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HISTORY 



OF 



YELLOW FEVER. Jj 




QUITMAN KOHNKE, M. D. 

Born ix 1S57, at Xatchez, ]Miss. 
Died June 26, 1909, at Covixgtox, La. 

Dr. Kohnke was one of the pioneers and most forci- 
ble expounders of the modern doctrine of the transmission 
of yellow fever by the Stegomyia Calopus. He com- 
menced teaching this doctrine in Louisiana and illustrated 
his lectures by lantern slides immediately after the report 
of the Reed Commission had been given publicity. Had 
his indefatigable labors in this direction to educate public 
opinion in the South received fuller recognition at the 
time, the experience of 1905 would have been an impos- 
sibility. He lived long enough to see the universal ac- 
ceptance of this doctrine and quarantine practices modi- 
fied in obedience to its teachings. 

Requiescat in Pace. 



HISTORY 

OF 

YELLOW FEVER 

By 
GEORGE AUGUSTIN. 



Assistant Secretary Louisiana State Medical Society; Assistant Secretary-Librarian Or- 
leans Parish Medical Society, New Orleans; Author of "Romances of New Orleans" 
and other Creole Stories. 

TO WHICH ARE ADDED THE FOLLOWING ARTICLES: 

MEDICAL. 

ETIOLOGY— G. FARRAR PATTON, Ex-Secretary Louisiana State Board of Health. 

PREVENTION— QUITMAX KOHNKE, Ex-President New Orleans Board of Health. 

PATHOLOGY— O. L, POTHIER, Pathologrist to Charity Hospital, New Orleans. 

DIAGNOSIS— HAMILTON P. JONES, Physician-in-Chief New Orleans Yellow Fever 
Hospital, Epidemic of 1905. 

TREATMENT— LUCIEN F. SALOMON, Ex-Secretary Louisiana State Board of Health 

PROGNOSIS— CHARLES CHASSAIGNAC, Dean New Orleans Polyclinic. 

THE LOUISIANA SYSTEM OF HYGIENIC EDUCATION— FRED. J. MAYER, Secre- 
tary Louisiana Sanitary Commission. 

HISTORY AND STATISTICS. 
THE PANAMA CANAL AND YELLOW FEVER— COL. W. C. GORGAS, U. S. Army. 
EPIDEMIC OF 1905. 

HENRY DICKSON BRUNS, M. D. 
CHARLES CHASSAIGNAC, M. D. 
LOUIS G. LeBEUF, M. D. 
JULES LAZARD, M. D. 
SIDNEY L. THEARD, M. D. 



NEW ORLEANS: 

Published for the Author by 

SE-ARCY & PFAFF Ltd., 

724-728 Perdido Street. 

1909. 



A 



^ 



- v^?' 



Copyright, 1909, 

By GEORGE AUGUSTIX, 

Xew Orleans. La. 



?^JI. A 2 o 1 2 1 
AUG 3 1909 



TO 

THAT CHIVAI.ROUS SOUTHERN GENTLEMAN, 

DR. CHARI.es CHASSAIGNAC, 

OF 

NEW ORLEANS, 

THIS VOLUME IS DEDICATED, 

As a Testimonial of the high esteem in which he is held in ^this com- 
munity, and in recognition of valuable assistance rendered 
in the compilation and classification of the 
Medical Part of this Work to 

THE AUTHOR. 



ACKNOWLEDGEMENTS. 

I specially desire to thank Major Walter D. McCaw, Sur- 
geon, U. S. A., Librarian Surgeon-General's Office, for his un- 
faltering courtesy in placing at my disposal the works contained 
in the Surgeon-General's Library. During the long years con- 
sumed in the compilation of this work. Dr. McCaw's promptness 
in lending me books necessary for research work has greatly 
facilitated my labors, and I desire to signify my heartfelt appre- 
ciation of his kindness. 

I desire also to thank Drs. W. C. Gorgas, Henry Dickson 
Bruns, Charles Chassaignac, Quitman Kohnke, Hamilton P. 
Jones, Jules Lazard, Louis G. Le Beuf, Fred. J. Mayer, G. 
Farrar Patton, Oliver L. Pothier, Lucien F. Salomon and Sidney 
L. Theard for the valuable articles contributed to this volume. 

THE AUTHOR. 
June 30, 1909. 



REMARKS BY THE AUTHOR. 

The original intention of the writer was to publish a bro- 
chure on "The History of Yellow Fever in Louisiana," the idea 
suggesting itself to him while acting as special stenographer in 
the office of the United States Marine Hospital Service at New 
Orleans during the Yellow Fever outbreak of 1897. The duty 
of copying the reports made by the medical staff under Surgeon 
Carter devolving upon him, the thought occurred to him that a 
statistical and historical compilation of the many epidemics of 
yellow fever which have afflicted our State would prove inter- 
esting. With this end in view, the work of collecting data was 
begun shortly after the mild epidemic of 1898. Such was the 
nucleus of this work. 

During the decade which has elapsed since the collection 
of data for this volume was begun, the original scope was en- 
larged, and as the years rolled by and the magnitude of the task 
became more and more evident, the author found himself con- 
strained to dodge around corners whenever he co'^'l « medical 
friend who had been assured that the book would be out "by 
the end of December" the year previous; and the patient, good- 
natured people of New Orleans, who had been told by cpmnl'- 
mentary articles in the public press, from time to time, that the 
work would "soon be issued," naturally reached the conclusion 
that the end would arrive simultaneously with the Millennium. 



No apology is made for the long-deferred appearance of 
this volume. A glance is sufficient to show that it is a work of 
love, for no aniount of financial gain (should it meet with public 
favor) could be adequate compensation for the time consumed 
in its compilation. Not being possessed of independent means, 
the author had to steal moments out of the busy work-a-day Hfe 
to complete his task, aided by his devoted wife, to whose valu- 
able assistance is chiefly due the completion of a work whioh, 
until very recently, seemed unending. 

It was the author's intentions also to include within these 
pages a history of the ravages of Yellow Fever in the West 
Indies and South America, but, judging by the time which has 
been consumed in the compilation of what is included in this 
volume, he has concluded that the span of life is too short for 
the accomplishment of such a task, and humbly submits the re- 
sult of his labors to the cynical public and to the judgment of 
indulgent friends. 

GEORGE AUGUSTIN. 

New Orleans, June 30. 1909. 



CONTENTS. 

PART FIRST. 
GBNERAI, OBSERVATIONS. 

CHAPTER I. 

THINGS EVERYBODY OUGHT TO KNOW. 

.X)efinition of Technical Terms: 

Epidemic 1 

Endemic ; 2 

Sporadic 2 

What Fomites Are 2 

The Difference Between Infection and Contagion 3 

What a Pandemic Is 4 

Brief Remarks on Quarantine 6 

CHAPTER II. 

THE RAVAGES OF PESTILENTIAL DISEASE. 

The Peculiar Pranks of Epidemics 7 

.Ancient Notions About the Origin of Pestilential Disease . . . ^ 9 

Odd Beliefs and Practices of Superstitious Ages 10 

An Extraordinary Historical Document 14 

Historic Mortalities Caused by Pestilences in Ancient and Medieval 

Times 17 

The Great Plagues of London 21 

CHAPTER III. 

THE GREAT EPIDEMICS OF THE MIDDLE AGES. 

The Inguinal Pestilence of the Sixth Century 22 

The Black Plague 27 

Le Mai des Ardents 30 

The Eruptive Fevers of the Sixth Century — ^Variola, Measles, 

S'Carlatina 35 

The Sweating Sickness 36 

Scurvy 38 

Xieprosy 39 

CHAPTER ilV. 

INSECTS AS PROPAGATORS OF DISEASE. 

How Pestilence is Spread by Flies, Mosquitoes, Fleas and Other 
Insects. — Instances Where Disease Was Conveyed by Bed- 
Bugs a-id Ants. — The Role Played by the CattleTick and the 
Tsetse-Fly. — ^Summary of the Mosquito Doctrine 44 

IBibliography of Transmission of Disease by Insects 52 



PART SECOND 



PRELIMINARY OBSERVATIONS ON YELLOW FEVER. 
CHAPTER 1. 

PERTINENT POINTS ABOUT YELLOW FEVER. 

Geographical Limits 63 

Mortality in September, as Compared with. Other Months 64 

Historic Mortalities Caused by Yellow Fever 66- 

CHAPTER II. 

NOMENCLATURE OF YELLOW FEVER. 

Peculiar Names Giren the Disease by Medical Writers. — A List Con- 
taining One Hundred and Fifty-two Synonyms 70- 

CHAPTER III. 

HISTORICAL SUMMARY.. 

Where was the Cradle of Yellow Fever? 85 

Critical Examinations of the Literature on the Origin of Yellow Fever: 

American Origin 87 

African Origin 100 

Asiatic Origin 105- 

The Gulf Stream Theory 10& 

First Recorded Outbreaks Ill 



PART THIRD. 



HISTORY OF Y^lvIvOW FBVBR BY I,OCAI,ITi:eS. 

ASIA. 

The Effect that the Completion of the Panama Canal will have upon . 

the Probable Extension of Yellow Fever to Asia — W. C. 

Gorgas, U. S. A ..135 

Alleged Yellow Fever in Syria 144 

AFRICA. 

History of Yellow Fever in Africa, Arranged Alphabetically, by 

Localities 150 to 343 

Chronology of Yellow Fever in Africa and the Islands off the Coast 

thereof, from 1494 to 1907 344 

Summary of Yellow Fever Years and Periods of Xmmunity 350 

Chronology, by Localities 352 

EUROPE. 

Austria. 
Trieste 356 

Azores. 

Historical Summary 357 

Ponta Delgado 358 

France. 

Historical Summary 359 

Chronology, 1694 to 1908 360 

Aix 363 

Bordeaux 364 

Brest 370 

Dunkirk 372 

Havre 373 

La Rochelle 375 

Marseilles 375 

Mindin 388 

Montoir- de-Bretagne 389 

Montpellier 389 

Nantes 390 

Paris 390 

Rochefort 396 

Saint-Nazaire 400 

Toulon 412 



AUGCSTIN S HISTORY OF YELLOW FEVER. 



Great Britain. 

Historical Summary 415 

Chronology, 1713 to 1878 416 

Cork 430 

Dover 419 

Dublin 430 

Falmouth 419 

Isle of Wright 419 

Llanelly 432 

London 42a 

Motherbank. (See Isle of Wight). 

Newca3tle-on-Tyne 421 

Portsmouth 422 

Salcombe 423 

Southampton 423 

Swansea 432 

Woolwich 44a 

Italy. 

Chronology, 1804 to 1883 447 

Genoa 447 

Leghorn 448 

Naples 452 

Pisa 453 

Torre Annunziata 454 

Varignana 456 

Portugal. 

Chronology, 1718 to 1880 460 

Belem 460 

Bom Successo 462 

Ericeira 462 

Lisbon 463 

Olivaes 475 

Oporto 475 

Peniche 480 

Spain. 

Historical Summary 483 

Geographical Description of Localities in Spain Where Yellow 

Fever has been Observed 484 

Chronology, 1649 to 1890 491 

Summary of Yellow Fever Epidemics, by localities: 
Aguilas 499 



CONTENTS, 5 

Alberca, Alcala de los Gazules, Alcala de los Panderos 500 

Alcantarilla, Algerziras 501 

Alliaurin-el-Grande, Alicante 502 

Antequera 504 

Arahal, Arcos de la Frontera 506 

Avriata, Ayamonte 508 

Badalona 509 

Balearic Islands 509 

Barcelona 516 

Barcelonette 522 

Barrios, Benaocaz ; 523 

Bornos 524 

Cadiz 524 

Caneta-de-Mar 544 

Caneta-la-Real, Carmona, Carraca, Carrana 545 

Cartagena , 546 

Catalan Bay 548 

Chiclana, Chipiona 549 

Churriana, Coin 550 

Conil, Cordova 551 

Coria, Cortes de la Frontera, Corunna, Dos Hermano3 552 

Ecija 553 

El Arahal, El Borge, El Palo, El Passajes, Eprezalena 554 

Espejo 555 

Espera, Estepa 556 

Ferrol, Fraga 557 

Gibraltar 557 

Granada, Guardamar 566 

Huelva, Isla de Leon 567 

Jesus, Jumilla 568 

La Charlotta, La Rambla 669 

Las Cabezas de San Juan, Las Palacios, Lebrixa 571 

Lorca 573 

Loyola 574 

Madrid 574 

Mairena del Alcor 576 

Malaga 577 

Malgrat 598 

Mazarron, Medina-Sidonia 599 

Mequinenza 600 

Mijas, Monte Alegre, Montejugue 601 

Montilla 602 

Mora, Moron de la Frontera, Murcia 603 

Nonaspe, Ojos, Olivera 604 

Olot 605 



AUGUSTIN S HISTORY OF YELLOW FEVER, 

Palma (See Balearic Islands). 

Palmar, Pasajes 605 

Paterna de la Ribiera, Pedrara 607 

PedroctLes, Penacerrada 608 

Port Malion. (See Balearic Islands). 

Puerto de Santa Maria 608 

Puerto Real 609 

Regens, Ricote 610 

Ronda 611 

Roquetas, Rota, Saint Eloy 612 

San Andero, Salou 613 

San Gervaiso, San Juan del Porto, San Lucar de Baramaeda 614 

San Roque, Sans, Sarria 615 

Seville 618 

Sitges 621 

Tabarca, Tobarra, Torre del Mar, Torre Molino 622 

Tortosa 623 

Totana, Tribujena 625 

Turriano, Ubrique, Utrera 626 

Valencia, Vejer, Velez Malaga 627 

Vera, Vigo 628 

Villa Martin 629 

Villanueva del Ariscal, Villaseca de la Sagua 630 

Xeres de la Frontera 630 

Ximena de la Frontera 633 

Yecla, Zieza 634 

HISTORY OF YBI^lyOW FEVER IN NORTH 
AMERICA. 

Proofs that Yellow Fever is an American Product and was Unknown 

to Europeans before the time of Columbus 639 

CANADA. 

Historical Resume 650 

Chronology, 1805 to 1880 652 

Summary of Yellow Fever Outbreaks, by Localities: 

Nova Scotia. 
Halifax 652 

Prince Edward Island. 
Charlottetown 656 



Quebec. 
Quebec 656 

Saint Pierre and Miquelon. 

Saint-Pierre-deMiquelon 658 

Bibliography of Yellow Fever in Canada 659 

CENTRAL AMERICA. 

Historical Resume 660 

Chronology, 1596 to 1908 661 

Summary of Yellow Fever Outbreaks, by Localities: 

Britisli Honduras. 
Belize 666 

Costa Rica. 

Alajuela 668 

Heredia, Liberia, Matina 669 

Port Limon 670 

Punta Arena. San Jose 678 

San Juan 679 

Zent 680 

Guatemala. 

Champerico, Chiquimula, Gualan 681 

Livingston, Puerto Barrios 682 

Tucara, Zucapa 683 

Honduras. 

Ceiba, Chamelicon 685 

Cholona, Cienaguita, El Pariso, Nacaome, Pimenta 686 

Puerto Cortez 687 

San Pedro 689 

Nicaragua. 

Bluefields, Corinto 690 

Granada, Jucunapa, Leon 691 

Managua, San Francisco 692 

Salvador. 

Acajitla, La Libertad 693 

San Salvador 693 

Santiago de Maria 696 

Bibliography of Yellow Fever in Central America 696 



8 AUGUSTIN S HISTORY OF YELLOW FE^ER. 

MEXICO. 

Historical Summarr of Yellow Fever in Mexico: 

Endemic Foci 70(^ 

Along tlie Pacific Coast TO^' 

G-eneral Retrospect 70S 

The General Epidemic of 1883 707 

Summary of Yellow Fever Epidemics in Mexico, by Localities: 

Acapulco, Acayucan, Altata, Altamera 708 

Alvardo, Amalco, Atai, Camarga, Campeclie 709 

Cardenas. Chilpanzingo 710- 

Cilas, Cinchapa, Clinidas, Coatzacoalcos, Colina 711 

Caraco 71? 

Concordia 713^ 

Cordova 713 

Corrientes 115 

Cosmaloapam, Cosala, Culican, Dofia Cecilia, El Higo, Equador, 

Frontera 71& 

Gualian, Guaymas, Guerrera, Guie-c'Mcori, Hermosilo 71T 

Hidalgo, HuacMnango, Huimangnillo, Ixcallan, Jalapa, Jicaltepec, 

Jico, Jiminez 718^ 

Joltipan, Juchitan, Laguna del Carmen, La Ju.nta, Lampasas, La 

Paz 119 

Las Animas, Linares, Mazanillo 720 

Matamoras 720 

Mazatlan 721 

Merida 721 

Mexico City — 

Experiments Demonstrating that the Yellow Fever Mosquito 

can Breed in Mexico City 723" 

Summary of Yellow Fever Importations to Mexico City 728 

Micaltepec, Mier 72& 

Minatilpan, Misantla, Monclava, Monterey 729 

Motul, Montzorongo, Xaulta IZO 

Xicayuca, Xeuva Laredo, Ocus. Omealca 731 

Orizaba 731 

Papantla, Paraje Xuevo, Paso de Ovijas, Pinchucalco, Presidio 734 

Progreso Peublo Vejo, r'eurto Angel, Quantana Roo, Reata 735 

Reynosa. Rosario, Salina Craz. San Antonio, (San Benito, San Bias. .736 
San Fernando, San Geromino, San Ignacio, San Juan Batista, San 

Lorenzo, San Luis Potosi 737 

Santa Cruz de los Rosales, Santa Lucretia, Santiago Acapemeta, 

Soconusco 738 

Tampico 73S 



CONTENTS. ^ 

Tamuin, Tapacliula, Tepee, Tehuantep.ee 74L 

Teran, Texistopee 742 

Tezonapa, Tierra Blanea, Tapona, Tlacoltipan, Tpislan, Tonala, 

Tuxpan 743 

Tuxtepee, Valladolid 744 

Vera Cruz (1509 to 1909) 744, 

Victoria, Xumpich, Yuki, Zonogolica, Zueatula 750 

Bibliography of Yellow Fever in Mexieo, by Localities 750 

UNITED STATES. 

General Summary 767 

Table Showing Years in which Yellow Fever has Invaded the Sea 

board Cities of the United States, 1668 to 1893 769 to 780 

History of Yellow Fever in the United States, by Localities: 

A abama 781 

Arkansas 792 

California 725. 

Connecticut 798 

Delaware 801 

District of Columbia 804 

Florida 805. 

Georgia 821 

Illinois 833 

Indiana 838 

Indian Territory 838' 

Kentucky .839 

Louisiana 844 to 902: 

Maine 915 

Maryland 917 

Massachusetts 525 

Michigan 936^ 

Mississippi 937 to 954 

Missouri 957 

New Hampshire 962 

New Jersey 96o 

New York 965 

North Carolina 982 

Ohio . . . 9S4 

Pennsylvania 986 

Rhode Island 993" 

South Carolina ^^^ 

Tennessee l^^l 

Texas 1«^9 

Virginia 1^^^' 

Vermont 1^^^ 

Washington 1^^'^ 

West Virginia l^^'^ 



10 

PART FOURTH 



HISTORY OF YELLOW FEVER EPIDEMIC OF 1S05. 



EXPERIENCES DERIXG THE YELLOW FEVER EPIDEMIC OF 

1905.— KEXRY DICKSON BRUNS. M. D 1027 



SOME LESSONS TArGHI EY THZ: EPIDE:\nC OF 1505.— 
CHARLES CHASSAIGNAC : I 

L Truth of Mosqniio P :;: 3^ :- 1049 

n. Infection in Proportion to Nnmber of Bites 1052 

m. Timlence Diminishes Pari Passu with the Destruction 

of Mosquimes 1053 

IT. Susceptibility of Negroes 1054 

V. Quarantines Unintelligent 1055 

VI. Prophylsxis in Place 1056 

Vn. Prophylaxis in Person 1057 

VUL Depopulation of Infected Places 1057 

IX. Detention Camps 1"5S 

X. The Great Lesson lOcS 

m. 

THE WORK OF THE MEDICAL PROFESSION OF NEW OR- 
LEANS DURING THE EPIDE:\nC OF 1905.— LOUIS G. 
LeBEUF, M. D. 

I. Preliminary Remarks; Local Medical Organizstion . . . 1060 

IL Appeal for Early Notification 1069 

in. Appeal for Immediate Screening of Suspected Cases, 

and Fnmigation 1071 

rv. Appeal for an Educational Campaign 1072s 

V. A Warning to Beware of the Danger of OTerlooking 
the Less Obvious Breeding Places of the 

Stegomyia 1073 

Yl. Appeal for a More Skilled Medical Body to Conduct 

the Campaign 1074 

VII. Letter Warning Medical Men not to Overlook the Mild 

Type of Yellow Fever which may be Found in 

the N2tive-Bom 1075 

Yin. Appeal to Householders to Delay "Moving Day" on 

Account of Danger of Spreading Infection 1076 

rx. Danger of Removal of Temporary Cistern Screens 1076 

X. Concluding Remarks 1077 



CONTENTS. 1 1 

IV. 

STATISTICAL REVIEW OF THE YELLOW FEVER EPIDEMIC 
OF 1905, NEW ORLEANS.— JULES LAZARD, M. D. 

I. General Remarks 1078 

II. "Suspicious" Deaths, 1905, Previous to Epidemic 

Period 1079 

III. Daily Record of Cases and Deaths and Cases Under 

Treatment 1081 

IV. Deaths Classified According to Age 1083 

V. Deaths by Months 1084 

VI. Deaths According to Nationality 1084 

VII. Comparative Mortality, 1904, 1905, 1906 1085 

V. 

ilEQUIREMENTS OF THE MOSQUITO DOCTRINE— S. L. 

THEARD, M. D 1086 

VI. 

:NEW ORLEANS YELLOW FEVER IN 1905.— S. L. THEARD, 

M. D 1093 

VII. 

AiNTI-MOSQUITO ORDINANCES ADOPTED BY THE CITY 

COUNCIL OF NEW ORLEANS IN 1905 1100 



12 

PART FIFTH. 



THE ACCEPTED MODERN THEORIES CONCERNING YELLOW 

FEVER. 



ETIOLOGY OF YELLOW FE\'ER— G. FARRAR PATTON, M. D. 

L First Definite Suggestion of tlie Truth HOT 

The Yellow Fever Germ 1109 

n. Views Formerly Held IIIL 

m. Tyranny of a False Doctrine 1116 

rv. Convincing Object Lessons cf 1905 1117 

V. Etiological Role of the Mosquito 1118 

VI. The Bacillus Icteroides 1124r 

\TI. Dengue and Yellow Fever 112(> 

11. 

THE SANITARY PREVENTION OF YELLOW FEVER— QUIT ]VL\N 
KOHNKE, M. D. 

L The Yellow Fever Mosquito 112T 

n. Moral Responsibility for Epidemics 112S 

IIL The Sanitary Creed 112^ 

IV. Mortality Statistics 1131 

V. Destruction of Stegomyiae 1133 

VI. Conditions Obtaining in New Orleans in 1905 1134 

yy^. Conclusions 1136 

BitlJGgraphy of Transmission of Yellow Fever by Mosquitoes 1138" 

III. 

PATHOLOGY OF YELLOW FEVER.— O. L. POTKIER, M. D. 

L Difficulty of Pathc^xOgical Diagnosis 114T 

IL Yellow Coior 1147 

III. Hemorrhs gic Spots 1148 

IV. The Lungs 1148 

V. The Heart 1148- 

YJ. The Liver 1149 

VII. The Spleen 1149 

VIII. The Kidneys HSO" 

IX. The Adrenals, Thyroids and Pancreas 1151> 



CONTENTS. 13 

X. The Stomach 115J 

XL The Intestines 1151 

XIL The Blood 1151 

XIII. The Nervous System 1151 

XIV. Adults More Susceptible 1152 

XV. General Steatosis the only Special Characteristic 

Lesion 1152 

IV. 

DIAGNOSIS OP YELLOW FEVER.— HAMILTON P. JONES, M. D. 

I. Preliminary Remarks 1154 

11. First Stage 1156 

IIL Second Stage 1156 

IV. The Blood 1157 

V. Urine 1157 

VI. Facial Expression 1157 

VII. Jaundice 1158 

VIII. Circulation 1158 

IX. Temperature 1158 

X. Pulse 1158 

XL Respiration 1159 

XII. Blood Pressure 1159 

XIII. Differential Diagnosis 

Malaria 1160 

Hemoglobinuric Fever 1161 

Dengue 1161 

La Grippe 1161 

Typhoid Fever 1161 

Acute Yellow Atrophy of the Liver 1162 

Weil's Disease 1162 

Catarrhal Jaundice 1162 

Acute Peritonitis 1162 

XIV. General Summary 1162 



PROGNOSIS OF YELLOW FEVER— CHARLES CHASSAIGNAC, M. D. 

I. Preliminary Remarks 1164 

IL Age 1165 

III. Condition of the Vital Organs 1166 

IV. Habits 11^^ 

V. Amount of Poison 1166 



14 AUGUSTIN's history of yellow F£VER. 

VI. Surroundings 1167 

VII. Race 1167 

VIII. Treatment 1167 

IX. Temperature 116& 

X. Icterus 1168 

XI. Urine 1168 

XII. Hemorrhage 1169 

VI. 

TREATMENT OF YELLOW FEVER— LUCIEN F. SOLOMON, 

M. D 1171 



VII. 



THE LOUISIANA SYSTEM OF HYGIENIC EDUCATION— FRED. 

J. MAYER, M. D 1176 



PART I 



GENERAL 
OBSERVATIONS. 



PART FIRST. 



CHAPTER I. 

TPIINGS EVERYBODY OUGHT TO KNOW. 

Definition of Technical Terms. — What is Meant by Epidemic, 
Endemic and Sporadic. — What Fomites Are. — The Difference Between 
Contagion and Infection. — What a Pandemic Is. — Brief Remarks on 
Quarantine. 

As this work is not solely for the use of physicians, but 
also for the information and guidance of the public, we 
wUl give a brief synopsis of the meaning of certain words 
which have be^n used quite freely by the lay and medical 
press recently, so that anyone who reads these pages will 
be perfectly familiar with technical terms which might 
otherwise seem confusing. 

Epidemic. 

The term Epidemic is applied to any disease which at- 
tacks a great many persons in a locality at any particular 
period and spreads rapidly in every direction, although 
every conceivable effort to check it or stamp it out is 
resorted to. 

The popular belief prevails among tJie laity that a 
disease is epidemic when the deaths from any cause exceed 
those from all other diseases occurring simultaneously in 
any locality. Such is not the case. A disease may be 
epidemic without having an unusual rate of mortality. 
This was illustrated by the epidemic of jaundice (some 
say it was yellow fever in its mildest form) which pre- 
vailed in Eotherham, England, in 1862. There were over 
three hundred cashes, with only one death. And yet the 
disease was decidedly epidemic. 



iIISTORY OF YELLOW FEVER. 

Endemic. 

A disease is said to be Endemic when it is permanently 
established or is ordinarily prevalent in a locality, and 
dependent on local conditions. 

Sporadic. 

SpGradic means that a disease manifests itself by the 
occurence of scattered or isolated cases, croi)ping out here 
and there, at irregular interyals, and easily amenable to 
remedial measures. 

FOMITES. 

The word Fomites has been juggled with so much by 
non-medical writers and by physicians who ought to ha^re 
knoAvn better, but who made use of the expression in a 
hap-hazard way, that we desire to call specie, 1 attention 
to its true etymology. Fomites is the plural of Fomes, 
and is derived from the Latin fomes, meaning touch-wood 
or tinder, or something which spreads quickly. It is ap- 
IDlied to any substance capable of absorbing, retaining and 
transmitting contagious or infectious germs. Such things 
as Avoolen clothes, moss, etc., are decidedly active Fomites, 
but it is impossible for wood, stone, iron, cork, books, 
newspapers or anything which does not retain germs, to 
propagate them. As yellow fever can only be transmitted 
by a certain species of mosquito, it cannot, under any con- 
dition whatsoever, be propagated by Fomites. Even if 
one T\'ears the garments of a person who has died of yellow 
fever, he can never contract the disease and vaW never be 
susceptible to it, unless he is bitten by a female Stegomyia 
Fasciata wliicli has bitten a yellow fever sufferer during 
the first three days of the attack. 

The only diseases believed to be capable of being trans- 
mitted by Fomites are cholera, typhoid fever, smallpox, 
scarlatina, diphtheria, tuberculosis, measles and eruptive 
and venereal affections. 

Prof. Beyer admirably sums up the question in the New 



THINGS EVCRYBODY OUGHT TO KNOW. 3 

Orleans Harlequin as follows:^ "A quarantine against 
any kind of freight is stupid. It is as silly as the disin- 
fecting of crude carbolic acid and pig-iron which occurred 
in Galveston during the last fever panic. Only the house 
mosquito conveys the disease. You can take a thousand 
people, all ill of yellow fever, into the most populous city, 
and if there are no mosquitoes in that city not one case 
will develop. With those thousand cases, the disease will 
end. * * * The genius of the world cannot take any 
article of freight and make it the transmitting agent of 
the disease." 

Further comment is unnecessary. In conclusion, we 
echo Prof. Beyer's sentiment, that this fact should be 
driven home to the intelligence of every community. 

The Difference Betaveen Infection and Contagion. 

Infectious. The pathological definition of Infectious is 
a disease capable of being communicated by contact, or 
through the medium of air, water or fomites. 

Contagious. Transmissible by contact. 

Infection is frequently confounded with Contagion, not 
only by the laity, but even by medical men. The best 
usage now limits Contagion to diseaises that are trans- 
mitted by contact with the diseased person, either directly 
by touch or indirectly by use of the same articles, by 
breath, or by eating or drinking after a diseased person. 
Infection is applied to diseases produced by no known or 
definite influence of one person upon another, but where 
common climatic, malarious or other widespread condi- 
tions are believed to be chiefly instrumental in their dis- 
semination. 

Yellow fever is neither contagious nor infectious. There 
are only two ways in which it can be transmitted : 

1. By the bite of the female mosquito of the genus 
Stegomyia Fasciata, which has previously fed upon the 
blood of a person suffering from yellow fever during the 
first three days of the attack. 

2. By inoculation with the blood of a yellow fever 

^August 3, 1905. 



HISTORY OF YELLOW FEVER. 



sufferer during the first three days of the attack ; after the 
third day, the disease cannot possibly be communicated. 

Pandemic. 

A Pandemic is an ei3idemic which attacks the whole or 
a greater part of the population of the world. It generally 
follows the routes of commerce, but has been known to 
ignore the by-ways of travel and to proceed by leaps and 
bounds, crossing wastes of waters and covering miles and 
miles of territory to reach a certain fated spot, without 
leaving a trace of its influence between the point of de- 
pai'ture and the locality it was destined to ravage. 

One of the most noteAvorthy pandemic waves of modern 
times began at the Cape of Good Hope in 1S22 and ended 
in the frigid zone seven years later, after having covered 
nearly the entire globe. Starting at the Cape, it traveled 
along the southern coast of Madagascar and reached the 
Island of Matiritius, in the Indian Ocean, in 1823. It was 
next felt in Ceylon, India and in some parts of Eastern 
Asia, after which it seems to have "doubled upon its 
ti^acks," for it stopped when it reached China and travelled 
A\'estward, skirting the sotithern coast of Asia and enter- 
ing the Mediterranean by way of Asia Minor, in the fall 
of 1821. It then successively invaded Malta, Gibraltar 
ajid some of the islands off the west coast of Africa. It 
next sojourned towards the north, reaching Great Britain 
the same year. Observers have recorded the fact that dur- 
ing the visitation of this pandemic, the admissions into 
the fever hospitals of London, Dublin, Glasgow and Edin- 
burg increased to an abnormal extent. The wave then 
crossed the Atlantic and was felt in the West Indies in 
the Autumn of 1821, where it caused a high rate of mortal- 
ity. Its influence seems to have lingered in that locality, 
for in 1825, Jamaica, in which had taken place the preced- 
ing year a slight advance in the death rate, experienced a 
terrible epidemic. By one of those strange and unaccount- 
able A'agaries which often characterize the phenomena of 
Nature, Ners^ Orleans was the only locality in the United 
States A^hich felt the influence of the wave; the mortality, 



THINGS EVERYBODY OUGHT TO KNOW. 5 

however, was not very great, the deaths froin yellow fever 
in 1824 aggregating 108, against 808 in 1822. 

The paudeniic then jumped, as it were, from the Gulf 
of IMexico to Canada,, where it caused much sickness and 
mortality in 1825, especially in Nova Scotia and the 
eastern provinces. The wave seems to have been loth to 
leave the British Isles, for its baneful influence was felt 
now and then throughout the United Kingdom from 1825 
to 1828, during which manifestatioins the death-rate rose 
to a notewo] thy degree. 

This remarkable pandemic finally spent itself on the 
frozen shores of Iceland in 1829, leaving in its wake 
throughout the island a series of epidemic diseases, in 
which typhus played a prominent role. 

liawson, \Aiio minutely noted the occurrence and in- 
fluences of pandemics, says:- 

''These waves occupy about two years in passing over 
a given station ; the mortality from fever, of whatever de- 
scription it may be, increases during their passage, 
subsiding again as they move onwards. They follow each 
other at intervals of a few years, and may be traced from 
the Cape of Good Hope, where they first become sensible, 
to Iceland. Some embrace Ceylon, in 80^ E. longitude, 
and New Orleans, in 90^ W. longitude, or nearly half the 
circumference of the earth. Were information for other 
places available, no doubt their passage might be demon- 
strated still more extensively.'- 
x\gain :^ 

^'The occurrences in the Mediterranean in 1828 are 
extremely interesting and important. There, under the 
same pandemic wave, while yellow fever was causing such 
mortality at Gibraltar as to induce many to think it an 
imported disease, the remittent fever, the und<)ubted pro- 
duct of the locality, was causing a much higher one at 
Santa Maura, and other forms of febrile disease^ — petechial 
typhus at Naples, and plague in Albania, — were prevailing 
on either side the latter. It must, therefore, be concluded 

^Lawson: Trans. Epidemiological Society of London, Vol li, 

1862. 
'' Ibid. 



HISTORY OF YELLOW FEVER. 



that though the pandemic cause determines the occurrence 
of febrile disease in places over which it passes, the 
peculiar form, and eren the frequency, of the disease is 
determined rather by the circumstances, whether meteo-o- 
logical, malarial, hygienic, or social, to which each popula- 
tion is subjected. The same local circumstances may exist 
in other years, and, so far as can be estimated, to an equal 
extent, but fevers do not become rife; but no sooner is the 
pandemic cause added, than these seem to acquire a 
potency which is almost inexplicable." 

Quarantine. 

Quarantine is derived from the Italian word quaranfina, 
which means a space of forty days, the period (originally 
forty days) during which a ship having a contagious 
disease on board, or coming from a port suspected of 
being infected Avith pestilential disease, is forbidden in- 
tercourse with the place at which she arrives. The period 
of quarantine in this country is generally from six to 
twenty days. 

Quarantine is practically abolished in England and its 
dependencies. If there is evidence or suspicion of in- 
fectious disease on board a vessel arriving in a British 
port, tlie customs oificers report the occurrence to the 
sanitary authorities of the port, whose decision in such 
matters is final. 

In the United States, by act of Congxess passed in 1888, 
national quarantine stations were established. This 
statute makes it a misdemeanor, i^unishable by fine or im- 
prisonment, or both, for the master, pilot or o\\'ner of any 
vessel entering a port of the United States, without first 
presenting a clean bill of health. 

Pratique is permission given to a vessel to unload with- 
out hindrance from quarantine laws. To do this, the 
vessel must present a clean bill of health. 

A comprehensive history of quarantine, from its earliest 
enforcement to the present day, will be found in the 
medical part of this volume. 



CHAPTER II. 

THE RAVAGES OF PESTILENTIAL DISEASE. 

The Peculiar Pranks of Epidemics. — Ancient Notions about the 
Origin of Pestilences. — Full Text of the Extraordinary Document 
Promulgated hy the College of Physicians of Paris in 1665. — An Out- 
line of the Appalling Mortality caused by Pandemics in Ancient and 
Medieval Times. — The Great Plagues of London. 

The Peculiar Pranks of Epidemics. 

Fortunately for the human race, it is seldom that two 
diseases are epidemic at the same time in the same locality. 
When yellow fever raged with such violence at Gibraltar 
in 1804, it Avas remarked that all other diseases declined ; 
and T^'ell they might, for in that great epidemic, out of a 
civil population of 14,000, only 28 escaped an attack. 

A similar retreat of inferior diseases has been observed 
to take plaee during the prevaJence of the plague in 
London, Holland and Germany, according to histories of 
that disease by Sydenham, Diemer brock, Sennertus and 
Hildamus. 

A modern instance of the malignity of yellovf fever took 
place at Yv^oodville, Miss., in 1844. When the fever broke 
out, all those ^^'ho could get away fled, and out of a total 
remaining population of 500 some 495 were attacked by 
the fever. 

There liave been notable exceptions to the rule that only 
one epidemic can rage at the same time. 

In 1889, both smallpox and measles were epidemic in 
England and Wales. 

Smallpox and scarlet fever were both epidemic in New 
York in 1840, 1841, 1842 and 1843; and in 1840 and 1841, 
measles Avas also epidemic, so that the three diseases were 
epidemic at the same time in the last mentioned years. 

In the year 1802, Charleston, S. C., was affected with 
four epidemics — smallpox, measles, yellow fever and 
influenza. 

It was a common occurrence, during the prevalence of 
cholera at New Orleans in the autumn of 1832, for a 



O HISTORY OF YELLOW FCVER. 

person to be attacked with yellow fever, and before, or as 
soon as the febrile excitement ceased, for the patient to 
be destroyed by the cholera in its most marked and malig- 
nant form. 

The cholera which was imported to^ New Orleans in 
1866 maintained its existence throughout the yellow fever 
epidemic of 1867, diminishing in its intensity as the fever 
advanced, and again becoming more malignant as the 
fever subsided. But it was never entirely absent. In 
November of that y^r, 234 deaths occurred from cholera 
and 103 from yellow fever; in December, when the fever 
had almost disappeared the mortalitv from cholera was 
210. 

In 1853, according to Fenner,^ there was a remark- 
able series of ei3idemic disease. We cull the following 
from his report, p. 1 : '^During the past year,^ two of 
the most terrible epidemic diseases that ever afflicted man- 
kind have prevailed, to a greater or less extent, in parts 
of the extensive region assigned to my notice.^ I mean 
cholera and yellow fever. Smallpox has also appeared in 
several i)laces; and other epidemics^ such as measles, 
scarlatina and whoo]3ing cough, have made us their cus- 
tomary annual visitations. '- 

^leasles and smallj)ox were also ei3idemic in Philadel- 
phia in 1823 and 1824, and in 1835 and 1845, smallpox, 
measles and scarlet fever were all epidemic. 

Measles and scarlet fever were both epidemic in Balti- 
more in 1837, and smallpox and scarlet fever in 1838, and 
again in 1845. 

In 1868, smallpox, cholera and yellow fever i^revailed in 
Cienfuegos, Cuba. 

Other instances could be cited, but these suffice for the 
purpose in view. 

P^pidemic diseases seem to be more fatal among the un- 
civilized than the civilized. In an epidemic of rubeola 

^Fenner: Report of the Epidemics of Louisiana, Mississippi, 
Arkansas and Texas in the Year 1853, by E. D. Fenner, 
1853. 

= 1853. 

•' The four States mentioned in above title. 



THE RAVAGES OF PESTILENTIAL DISEASE. y 

among the Crees (a tribe of North American Indians) in 
the summer of 1846, as reported by Dr. Smellie in the 
Monthly Journal of Medical Science for December, 1846, 
of 145 cases treated in his camp, 40 were fatal. 

Smallpox has sometimes swept off an entire tribe of 
Indians, as ^\'as the case with the Mandans (another North 
American tribe), and has generally proved abnormally 
fatal when it attacked the Ked Eace. 

It has been obseaved by Gregory^ that epidemics are 
usually severe when they first appear in a country or are 
renewed after any long intervals of time. When cholera 
first invaded India in 1817, it raged with an intensity 
which may have been equalled, but never has been sur- 
passed. When smallpox first made its appearance in 
America (Mexico) in 1518 and gangrenous sorethroat 
(diphtheria) first visited Naples in 1618, America in 1735 
and London in 1747, the ravages of each disorder were 
terrific. It seems, then, to be the law of animal economy 
that the susceptibility to any morbid poison is great in 
proportion as it has been little accustomed to the impres- 
sion. 

Ancient Notions about the Origin of Pestilential 

Disease. 

The works of Tlipocrates contain many interesting ob- 
servations upon the origin and nature of epidemics. He 
states that disease, in general, may be said to arise either 
from the food we eat or the air we breathe. When, there- 
fore, a disease seizes upon a multitude of persons of dif- 
ferent sexes, ages and habits, he infers that it must arise 
from the latter cause. ^ In his first book, fourteen 
cases of diseaise are related, and in the beginning of the 
third book, twelve, and sixteen in the end, thus making 
forty- two in all. It is worthy of remark that in twenty- 
five of these the result was fatal. There is every reason 
then to suppose that they were selected for a purpose, but 
what that purpose was cannot now be easily determined. 

* Gregory: A Treatise on Eruptive Fevers (1851), p. 35. 
^Paulus Egineta (Adams' translation). Vol, 1, p. 274. 



]0 HISTORY OF YELLOW FEVER. 

The most natural result would no doubt have been to 
illustrate the different pestilential diseases which are 
described as occurring at the time.^ 

Galen also attributes the origin of epidemics to the state 
of tlie atmosphere, but holds that the nature of the country 
may contribute. Lucretius accounts for the prevalence of 
epidemics upon similar principles, and Silius Italicus 
refers an epidemical fever to the same cause. 

The purif ving of the afmosphere as a means of prevent- 
ing or liiniting the spread of disease, is as old as the world 
itself. It is reported of Hippocrates that he changed the 
morbific state of the atmosphere of Athens by kindling 
fires. Plutarch also makes mention of one Acron, of 
Athens, wlien the great plague visited that city at the 
commencement of the Pelo-ponesian war, and attributes to 
him the advice that was given to the Athenians to kindle 
large fires throtighout the streets, with the view of purify- 
ing the air, which is the same i^lan as was adopted by the 
priests of Egypt." 

Pliny also speaks of fires as a corrective of the state of 
the atmosphere, and Herodotus relates that fumigation 
with aromatics were recommended as a preventive of the 
plague.^ 

Odd Beliefs and Practices of Supekstitious Ages. 

The ancients attributed to their gods the authorship 
of epidemics, and tinder this belief, religious sacrifices 
were made to ajDpease their anger. Terror-stricken and 
demoralized, they abandoned all measures calculated to 
give them protection and relief and relied solely upon 
their offerings and theii* prayers at the foot of the altai* 
for preservation. Cardan and Valesco de Tarente did 
not fear to attribute the origin of disease to the in- 
fluence of certain planets, while Xat. Webster, an Ameri- 
can physician, gives also more than fifty instances of the 
concurrence of an epidemic Avith some commotion of 

'^Hippocrates (Adams' translation), Vol. 1, p. 342. 
'Histoire de Medecine (Leclerc), Vol. 1, p. 57. 
•* Paulus Egineta, Vol. 1, p. 174. 



THE RAVAGES OF PESTILENTIAL DISEASE. 1 1 

nature, such as earthquakes, volcanic eruptions and the 
appearance of comets, Jackson, Joubert and others, liave 
dwelt ui)on the influence of the moon upon epidemic 
disease; and during the plague that nearly depopulated 
Paris in 1580, Asiien forty thousand people were swept 
away, the sky was so clear and serene, that the stars were 
looked to as the cause A^hicli could not be found in the 
atmosphere.^ 

According to researches made by Eager,^^ in the 
earliest period, superstition and stellar influence took the 
principal place in the confused ideas of etiology. Ill- 
ordered doctrines led to all sorts of irrational practices. 
Among the Greeks, in the rites of Esculapius, the sick 
were not pcj-mitted to enter the temples, where they un- 
derAvent ti eatment, Avithont first being purified by various 
baths, frictions, and fumigations. All this was accom- 
panied by ceremonies similar to those practiced within 
the temples, namely, magical performances and fervent 
prayers recited in a loud voice, often with musical ac- 
companiment. As an accessory to the purification prelim- 
inary to being admitted, the patient was required to pass 
the night sta^etched on the skin of a sheep that had been 
offered as a sacrifice. Here he was ordered to compose his 
mind for sleep and await the arrival of the physician. 
Throughout these ages as Avell as in more recent times a 
fanciful association between the phenomena of the 
material world and the destinies of mankind closely 
linked the doctrine of etiology with aistrology. Thcii per- 
sistent belief of learned men in the relation of stellar con- 
ditions to epidemics is in part explained by the fact that 
astrologers Avho predicted epidemics wrought charms 
against the impending pestilence, thus saving their credit, 
in event the disaster did not materialize, by claiming that 
it had been averted through their elTorts. 

These primitive views of the origin of epidemics did not 
necessarily place the cause of the disease outside the earth 
and its immediate surroundings. Winds, thunder and 

•'Chastant: Observations on Yellow Fever, 1879, p. 5. 
^•^ Eager: The Early History of Quarantine (Yellow Fever 
Bulletin No. 12, U. S. Treasury Dept), 1903, page 7. 



12 HISTORY OF YELLOW FEVER. 

lightning, fogs, and even meteors were blamed for caus- 
ing pestilence, and the flight of birds and insects were 
supposed to be dependent phenomena. 

Xanaphanes, Ave hundred or six hundred years before 
Christ, expounded an idea that the sun was a torch and 
tlie stars candles that were put out from time to time. 
According to his notion, which was seriously accepted, 
the stars were not heavenly bodies in the wider sense, but 
meteors thrown off from the earth. So a belief in stellar 
influence did not carry the mind outside worldly ranges. 
For this reason other practices than j^rayers and sacrifices 
were belicA'ed to be effective. They consisted chiefly in 
efforts to dissipate the meteors, such as huge and numer- 
ous fires, and to avoid meteoric influence by confinement 
in closed or otherwise protected places. 

^'During the period under consideration," concludes 
Dr. Eager, ^'the promptings of superstition were para- 
mount and the epidemiologists of the times confined them- 
selves principally to interpreting the signs of the heavens. 
More advanced views came as the result of reasoning, but 
the path of discovery by experimental science was not 
entered upon until after many centuries." 

It Avas a common practice among the Phenicians to 
immolate their children during the prevalence of epi- 
demics, ho]3ing thereby to appease the anger of the gods 
and put a stop to the pestilence. 

Plutarch relates the manner of Esop's death, B. C. 581. 
The famous fabulist went to Delphi with a great quantity 
of gold and silver to offer, in the name of Cresus, a great 
sacrifice to Apollo, and to give each inhabitant a con- 
siderable sum. A quarrel arose between Esop and the 
people of Delphi, occasioning hini afterwards to send back 
the money to Cresus. The people of Delphi caused him 
to be condemned as guilty of sacrilege, and to be thrown 
from the top of a rock. The god, offended by this action, 
punished them with a plague and famine, so' that, to put 
an end to these e^ils, the terrorized Delphians offered to 
make reparation to any of the relatives of Esop. ^'At the 
third generation," continues Plutarch, ^'a man presented 
himself from Samos. The Delphians made this man re- 



THE RAVAGES OF PESTILENTIAL DISEASE. 13 

paration or satisfaction, and thereby delivered themselves 
from pestilence and famine which distressed tliem."^^ 

Epidemic disease was frequent in Greece before the 
Christian Era. The Athenians were wont to make annual 
sacrifices to Toxaris, '^the foreign physician," because 
their city Imd been delivered from the plague by his means, 
or rather by a woman Avho had dreamed that Toxaris, who 
dwelt at Athens, had told her that the pestilence would 
cease if they washed the streets with wine, "which they 
did, and the plague ceased immediately." 

In the year 665 B. 0., Thaletes, the Milesian, is reputed 
to have put a stop to an epidemic which had baffled the 
skill of the most renowned physicians of the time, by the 
influence of music. Had Thaletes lived in the present age, 
he Avould undoubtedly have amassed a princely fortune by 
stating what particular make of instrument he used. Un- 
fortunately, history is silent on this point. 

In the year B. C. 534, a terrible plague raged at Car- 
thage. The devastation was soi great, that the people sac- 
rificed their children to appease the gods. 

According to Niebuhr/^ the eruption of Mount Etna, 
which took place in the 81st. Olympiad, coincided exactly 
with the pestilence which devastated Rome about that 
period. The same authority says that in the year 301, 
the Nortliern Lights could be distinctly seen in Italy and 
were -'eminently connected with the fermcmt in the bowels 
of the earth." In the year 290, and also 295, the firma- 
ment seemed to be on fire, ''broken by flashes of lightning; 
armies and the tumults of battles were seen in the sky and 
sounds were heard which heightened the terror of this 
phenomenon." 

Dr. Howe (quoting Mebuhr) also speaks of another 
phenomenon which is said to have occurred in the year 
295, and observes that, however incredible it may seem, 
"it ought not to be rejected as an idle tale." The para- 
graph referred to reads as follows : 

^^Howe: Epidemic Diseases, 1865, p. 21. 

^'Niebuhr: Lectures on Roman Historie (Howe, loc. cit, p. 
85). 



14 HISTORY OF YELLOW FEVER. 

'^There fell, we are told, a shower of flakes like flesh, 
T^'hlch the birds devoured. What remained on the ground 
did not rot." 

No explanation is made of this alleged phenomenon, 
except in metaphors, which, when carefully sifted, ex- 
plain nothing, as is usually the case with metaphors. 

In the Year of Kome 300, a plan was adopted to cause 
the cessation of the plague which had afflicted Kome 350 
years from its foundation. The Komansi, by the advice 
of their oracle, sent ten deputies to Epidaurus, a town in 
ancient Greece, in the Peloponesus, celebrated for its 
magnificent temple of Esculapius. Thei delegatiou was 
headed by Quinctus Ogulnius, and the object was to bring 
the statue of Esculapius to Kome, as a means of stopping 
the ravages of the pest. On their arrival at Epidaurus, 
and while they were admiring the statute of Esculapius 
for its extraordinary size, the Komans perceived, emerg- 
ing from the base of the statue, a serpent. This unexpect- 
ed apparition, instead of causing dread and consternation, 
Avas regarded as a good omen by those present and im- 
pressed upon their minds feelings of awe and veneration. 
The serjjent glided through the crowd, sped swiftly 
through the streets of the town — followed by the populace 
— and betook itself to the vessels of the Komans and went 
straight to the apartment of Ogulnius. The Komans im- 
mediately erected a temple to Apollo, and the pestilence 
ceased.^^ 

An Extraordinary Historical Document. 

One of the most remarkable theories concerning the 
origin of epidemic disease was solemnly promulgated by 
the Faculty of Paris in 1665, to account for the ravages 
of the Black Plague, which was then devastating Europe. 
The pestilence commenced in December, 1664, and ended in 
January, 1666, a period of thirteen months. The learned 
medical men of France assembled at Paris in June, 1665, 
in order to discover the cause of the epidemic and devise 

" Leclerc : Histoire de Medecine. 



THE RAVAGES OF PESTILENTIAL DISEASE. l5 

sanitary measures to arrest its progress. After much 
deliberation, the conclaye finally evolved the extraordin- 
ary document copied below, which, at this day, would be 
vieAved in the light of a burlesque, but which was looked 
upon as an oracular pronunciamento by the superstitious 
people of the time. We think the document possesses 
feuch an element of quaintness and absurdity, that we pub- 
lish it in full : 

''We, the Members of the College of Physicians, of 
Paris, have, after mature consideration and consultation 
on the present mortality, collected the advice of our old 
masters in the art, and intend to make known the cause 
of this pestilence, more clearly than could be done ac- 
cording to the rules and principles of astrology and 
natural sciences; we, thereifore, declare as follows: 

''It is known that in India, and the vicinity of the Great 
Sea, the constellations which combated the rays of the sun, 
and the warmth of the heavenly fire, exerted their power 
especially against that sea,, and struggled violently with 
its waters. ( Hence, vapours often originate which en- 
velope the sun, and convert his light into darkness.) 
These vapours alternately rose and fell for twenty-eiglit 
days; but at last, sun and fire acted so powerfully upon 
the sea, that they attracted a great portion of it to them- 
selves, and the waters of the ocean arose in the form of 
vapour; thereby the waters were, in some part, so cor- 
rupted, that the fish which they contained, died. These- 
corrupted waters, however, the heat of the sun could not 
consume ; neither could other wholesome water, hail or 
snow, and dcAV, originate therefrom. On the contrary, 
this A apour spread itself through the air in many places 
on the earth, and enveloped them in fog. 

"Such was the case all over Arabia; in a part of India; 
in Crete; in the plains and valleys of Macedonia; in 
Hungary, Albania and Sicily. Should the same thing 
occur in Sardinia, not a man will be left alive; and the 
like will continue, so' long as the sun remains in the sign 
of Leo, on all the islands and adjoining countries to which 
this corrupted sea-wind extends, or has already extended 
from India. If the inhabitants of those parts do not 



HISTORY OF YELLOW FEVER. 



employ and adhere to the folloAving, or similar means and 
precepts, we announce to them inevitahle death, except the 
grace of Christ preserve their lives : 

^'We are of opinion, that the constellations, with the 
aid of Nature, strive, by virtue of their divine might, to 
protect and heal the human race; and to this end, in union 
with the rays of the sun, acting through the power of 
fire, endeavor to break through the mist. Accordingly, 
within the next ten days, and until the 17th of this ensuing 
month of July, this mist will be converted into a stinking 
deleterious rain, whereby the air Avill be much purified. 
Now, as soon as the rain shall announce itself, by thunder, 
or hail, every one of you should protect himself from the 
air; and, as well before as after the rain, kindle a large 
fire of vijie-wood, gTeen laurel or other green wood ; worm- 
wood and chamomile should also be burnt in great quanti- 
ty in the market places, in other densely inhabited locali- 
ties, and in the houses. Until the earth is again com- 
pletely dry, and for three days afterwards, no one ought 
to go abroad in the fields. During this time, the diet 
should be simple, and people should be cautious in avoid- 
ing (Exposure in the cool of the evening, at night, and in 
the morning. Poultry, and water fowl, young pork, old 
beef, and fat meat, in general, should not be eaten; but 
on the contrary, meat of a proper age, of a warm and dry, 
but on no account of a heating and exciting nature. Broth 
should be taken, seasoned with ground pepper, ginger and 
cloves, especially by those Avho are accustomed to' live 
temperately, and are yet choice in their diet. Sleep in the 
day-time is detrimental; it should be taken at night until 
sunrise, or some^vhat longer. At breakfast, one should 
drink little; supper should be taken an hour before sun- 
set, when more may be drunk than in the morning. Clear 
light wine, mixed wdth a fifth or a sixth part of water, 
should be used as a beverage. Dried or fresh fruits, with 
wine, are not injurious; but highly so without it. Beet 
root or other vegetables, whether eaten pickled or fresh, 
are hurtful ; on the contrary spicy pot-herbs, ais sage and 
rosemary, or wholesome. Cold, moist, watery food is in 
general prejudicial. Going out at night, and even until 



THE RAVAGES OF PESTILENTIAL DISEASE. 17 

three o'clock in the morning, is dangerous, on acconnt of 
the dew. Only small river fish should be used. Too much 
exercise is hurtful. The body should be kept warmer 
than usual, and thus protected from moisture and cold. 
Kain water must not be employed in cooking, and every 
one should guard against exposure to wet weather. If it 
rain, a little fine treacle should be taken after dinner. Fat 
people should not sit in the sunshine. Good clear wine 
should be selected and drunk often, but in small quanti- 
ties, by day. Olive oil as an article of food is fatal. 
Equally injurious are fasting and excessive abstemious- 
ness, anxiety of mind, anger, and immoderate drinking. 
Young people, in autumn especially, must abstain from all 
these things, if they do not wish to run a risk of dying of 
dysentery. In order to keep the body properly opened, an 
enema, or some other simple means, should be employed, 
when necessary. Bathing is injurious. Men must pre- 
serve chastity as they value their lives. Everyone should 
impress this on his reicollection, but especially those who 
reside on the coast, or upon an island into which the 
noxious wind has penetrated." 

Htstortc Mortalities Caused by Pestilence in Ancient 
AND Medieval Times. 

If we were to compute the total mortality from pestilen- 
tial disease from the earlist times to the present day, the 
figure would be appalling and almost beyond credulity. 
Pandemics have played havoc with the human race. At 
times, half the pop|ilation of the world was swept away 
before an epidemic had run its course; it spared neither 
man nor beast, but surged like an overcharged torrent 
over leagues and leagues of country, overleaping the 
highest mountain summits, swirling over miles of desert 
land, crossing rivers, lakes and even seas, and finally, like 
a huge beast that has gorged itself to suffocation, ceasing 
its awful carnage for want of new material. 

We shall cite only the most notable examples of great 
mortality. 



18 ' HISTORY OF YKLLOW FEVER. 

The greatest mortality caused by a single pestilence took 
place in Egypt in 1792/when 800,000 persons are reported 
to have perished. 

The next greatest mortality on record occurred in 
^^aples and vicinity in 1656, where, in six months, 400,000 
perished, almost depopulating that section of Italy. 

From December, 1664, to January, 1666, a period of 
thirteen months, the ''Great Plague" of Loudon caused a 
mortality of 69,000. 

Even ''Bonnie Scotland" comes in for a niche in the 
cinnals of epidemiology, for it is of record that a pestilence 
carried off 40,000 of her sons in A. D. 954. 

Let us now take a peep into antiquity. 

In the 1017 B. C, ''David, being elated with success, 
God sends a grievous pestilence, of which 70,000 died in 
less than three days." 

in 594 B. C. a third of the inhabitants of Jerusalem 
perished by pestilence. 

In 480 B. C, while the army of Xerxes Avas retreating 
into Asia, after the battle of Salamis, 150,000 died from 
pestilential disease. 

In 395 B. C, a terrible plague attacked Himilco's army, 
which was on its way to sack and destroy Swacuse; 50,000 
died. 

In 378 B. C, according to Howe,^^ immediately after 
the arrival of the troops from Italy, Carthage had a most 
ten-ible calamity to struggle with. "The plague broke out 
afresh there and swept away an infinite number of in- 
habitants. This seems to have raged with gTeater violence 
than any distemper the city was ever visited with before, 
for such vast multitudes were carried off by it, that the 
country was, in a manner, depopulated." 

In B. C. 188, a great plague raged in the Greek Islands, 
Egypt and Syria, and destroyed 2,000 persons daily. 

In the reign of the Echeopean king, Micipsa (B. G. 125), 
according to Orosius, a great part of Africa was covered 
with locusts, which died by billions, causing a plague, 
which swept away an incredible number of people. In 

"Howe, loc. cit, p. 57. 



THE RAVAGES OF PESTILENTIAL DISEASE. 19 

Kuinidia alone perished 800,000 persons, and in Africa 
proper 200,000, and also 30,000 Roman soldiers quartered 
about Ulica. At Utiea, particularly, the mortality raged 
to such a degree that 1500 dead bodies were carried out by 
one gate in one day. 

In B. C. 22, Rome was about depopulated by plague and 
famine. 

In A. D. 77 and 78 a most appalling pestilence raged in 
Southern Europe; 10,000 persos perished daily. 

In A. D. 717 an epidemic carried off 50,000 of the 
inhabitants 6t the then known world. 

In the Year of Rome 666, ^'all of a sudden the plague 
manifested itself, but with such violence, that in a few 
da^^s it carried off eleven thousand men." 

In the year of Rome 540, during the siege of Syracuse 
by Marcellus (according to Catrou and Rouille, Histoire 
Romaine, vol. 8, p. 152), it appears that Heaven took 
pleasure to combine all the scourges of its anger against 
unfortunate Syracuse. In addition to other calamities, 
a pestilence supervened to afflict the city. At first, the 
contagion commenced in the coiuntry. The heat, of the 
climate and the season had corrupted the air, and the filth 
which the sea ordinarily leaves upom the shore when the 
waters retire, had still further deteriorated it. The two 
camps of Himilco and Crispinus were first attacked. Then 
the malady communicated itself to the army of Marcellus, 
from the intercourse with that of Crispinus. Soon after 
Acredina was attacked by the pestilence. Thus aro^und 
the city, and in the interior of it, nothing was seen but 
the dead and dying. From the fear of catching the infec- 
tion by approaching the dead bodiesi, they were left with- 
out burial, to poison the place where they lay decompos- 
ing. Hippocrates and HimilcO' died of the scourge. 

The plague which broke out in the army of Sennacherib 
(B. C. 709), is said to have caused a mortality of 185,- 
000. This was regarded by the Jews as a punishment of 
Divine Providence, meted out to Sennacherib for having 
invaded Judea. 

During the plague of Rome (A. D. 256), 2,000 persons 
were buried daily. 

In the year 89 B. 0., while Pompeius, a Roman general, 



20 HISTORY OF YELLOW FEVER. 

was leading an army against Marius, the Carthaigenian, 
a plague broke out among the soldiers, which carried 
away 11,000 men in a feAV days. 

From A. D. 716 raged the great plagnie of Constanti- 
nople, which destroyed nearh^ 300,000 people in that 
historic city. In 1611, after a j)eriod of eight hundred 
and fifty-two years, occurred the second ''great plague" 
of Constantinople, when 200,000 persons are said to have 
perished. 

In A. D. 772, an epidemic carried off 31,000 of the popu- 
lation of Chichester, England. 

In 1545, the "Trousse Galante" swept away 10,000 of 
the foreign population of Boulogne, France. The fatali- 
ties among the natives could not be ascertained. 

''In 1115,'- says Sauvel, "from the month of August to 
St. Andre's Day (NoYember 30), 6,000 infants died in 
Paris from smallpox. "^^ 

The "Black Plague" of the fourteenth century was one 
of the most appalling iDestilences which swept the earth. 
In the space of four years, 12,836,186 persons died. Asia, 
exclusive of China, lost 10,810,000. China alone lost 13,- 
000,000 inhabitants. In Europe, the mortality reached 
the appalling figure of 18,916,186, Germanv alone losing 
12,000,000 souls.16 

In 1773, Persia was devastated by an awful pestilence. 
In the City of Bussorah alone, 80,000 perished. 

In 1799, the city of Fez, Africa,, lost 217,000 of her 
population by pestilence. 

In 1799, 3,000 persons died daily in Bombay, India. 

The fever which swept over the Coromandel Coast, 
India, in 1809, 1810 and 1811, caused the loss of 106,789 
out of a population of 1,828,610. 

The ravages of the glandulas plague were enormous. In 
London, in 1625, it carried off not less than 35,117 indi- 
viduals; at Lyons, in 1628-29, in a population of 200,000, 
it is reported that 50,000 died ; at Marseilles, in 1720, the 
morta lity was 40,000 ; at Cyprus, in 1760, the deaths were 

'' Sauvel : Histoire et Recherches des Antiquitees de la Vilie 

de Paris. 
'^Ozanam: Histoire Medicale, etc., des Maladies Epidemiques, 

1835, vol. 4, p. SG. 



THE RAVAGES OF PESTILENTML DISEASE. 21 

70,000 ; at Meppo, 1761-62, the plague carried off 21,800 
and in 1796-97, in the same city, the mortality amounted 
to 60,000. 

In 1720-21, in the space of seven months, 60,000 persons 
died of the plague at Marseilles, France. 

The Great Plagues of London. 

London shares the palm with Rome for having been the 
nidus of the plague from nebulous times. As early as 207 
A. D., when Severus invated Britian, 50,000 of his soldiers 
perished from a pestilence which was then ravaging the 
island. Not counting the lesser epidemics, in which the 
mortality amonnted ''only to a few thousands," the follow- 
ing table will show the appaling havoc wrought by pestil- 
ence in London, without counting the balance of Britain, 
in the short period of forty-four years : 

Table of Deaths from all Diseases and from Pestilence in 
London, England ^ from 1592 to 1636. 

Year. Mortality from Mortality from 

All Diseases. Plague Alone. 

1592 .. 25,886 11,503 

1603 37,294 30,561 

1625 51,758 35,403 

1630 10,545 1,317 

1636 23,359 10,400 

Total mortality during 

forty-four years 119,042 89,184 

It is thus seen that out of a total mortality of 119,042 
from all diseases, the plague carried off 89,184. 

In December, 1664, twenty-eight years after the terrible 
visitation of 1636, began what is known to history as the 
^'Great Plague of London." From its inception to 
January, 1666, a period of only thirteen months, it caused 
a mortality of 69,000. Some historians place the figures 
as high as 100,000. 

In 1666, also occurred the "Great Fire," which spread 
over 396 acresi, destroying over 13,2000 houses, ninety 
churches and many public buildings. 



CHAPTER III. 

THE GREAT EPIDEMICS OF THE MIDDLE AGES. 

The lugiiinal Pestilence of the Sixth Century. — The Black Plague or 
the Fourteenth Century. — Le Mai des Ardents. — The Eruptive Fevers 
of the Sixth Century. — The Sweating Sickness. — Notable Epidemics of 
Scurvy. — Leprosy and its Attendant Horrors. 

THE IXGUIXAL PESTILENCE OF THE SIXTH CENTURY. 

(Up to the year 1831, when the •'Fragments" of Ruffus were published, 
the prevailing opinion had been that Procopius, the Greek historian, 
was the first to give a description of the Glandular Plague of the East. 
Even after the publication of this remarkable work, such distinguished 
historians as Hecker, Rosenbaum, Fariset and Navman still gave the 
honor to Procopius, claiming that the newly-discovered manuscript 
was spurious. The passage referred to reads as follow^s: '"The 
buboes called pestilential are most fatal and acute, especially those 
which are seen occurring about Lybia, Egj^pt and Syria, and which 
are mentioned by Dionysius Curtus. Dioscorides and Posidonius make 
much mention of the plague which occurred in their time in Lybia; 
they saw it was accompanied by acute fever, pain and prostration of 
the whole body, delirium, and the appearance of large and hard 
buboes, w^hich did not suppurate, not only in the accustomed parts, but 
also in the groins and armpits." According to Adams, the only thing 
which detracts from the value of this paragraph is the diflBculty of 
determining exactly who the authorities are which are referred to in 
it. Of Dionysius Surtus nothing is known; indeed, it is more than 
probable that there is some mistake in the name. There are several 
medical authors by the name of Dioscorides and Posidomius, and it 
is diflacult to determine to which of them reference is made. Still, 
Adams finds no reason for questioning the authenticity of the passage. 
Ruffus flourished in the reign of Trajan, in the beginning of the 
second Century. The graphic description of this terrible pestilence 
and other epidemics of the Middle Ages, has been abstracted from the 
masterly translation of Dr. Dupuy's "Le Moyen Age Medical," by Dr. 
Thomas C Minor of Cincinnati These articles were originally pub- 
lished in the Cicinnati "Lancet- Clinic," of which Dr. Minor is associate 
editor, and an abstract is published in this volume by special p.ermis 
sion. — G. A.) 

In the sixth century after Christ, occurred the terrible 
epidemic known bj the name of the ''Inguinal Pestilence," 



THE GREAT EPIDEMICS OF THE MIDDLE AGES. 2S 

which, after ravaging Constantinople spread into Liguria, 
then into France and Spain. 

According to Procopius/ it attacked the entire earth, 
striking every race of people, sparing neither age nor sex ; 
differences in habitation, diet, temperament or occupa- 
tion of any nature did not stop its ravages; it prevailed 
in summer and in winter — in fact, at every season of the 
year. 

It commenced at the town of Pelusa, in Egypt, whence 
it spread by two routes, one through Alexandria and the 
rest of Egypt, the other through Palestine. After this it 
covered the whole world, progressing always by regular 
intervals of time and force. In the springtime of 543 it 
broke out in Constantinople and announced itself in the 
following manner : 

Many victims believed they saw the spirits of the de- 
parted rehabilitated in human form. It appeared as 
though these spirits appeared before the subject about to 
be attacked and struck him on certain portions of the 
body. These apparitions heralded the onset of the malady. 
The commencement of the disease was not the same in all 
cases. Some victims did not see the apparitions, but only 
dreamed of them; but all believed they heard a ghostly 
voice announcing their inscription on the list of those 
who were going to die. 

The fever at the onset of the attack came on suddenly, 
— some while sleeping, some while waking, some while at 
work. Their bodies exhibited nO' change of color, and the 
temperature was not very high. Some indications of fever 
were perceptible, but no signs of acute inflammation. In 
the morning and at night the fever was slight, and in- 
dicated nothing severe either to the patient or to the 

^ Procopius, the Greek Historian, born at Caesarea in the year 
500, left behind him numerous works, among which may 
be enumerated L'Histoire de Son Temps, in eight volumes 
(Procopii Caesariensis Historian sui temporibus). This 
history of the times by Procopius gives a full description 
of the plague, and is one of the chef d'oeuvres of medical 
literature, one that will never be excelled. In this work, 
nothing being omitted, not even the diiferent clinical 
forms, it is truly classical. 



2i HISTORY OF YELlOW FEVER. 

physician who counted the pulse. Most of those who 
presented such symptoms showed no indications of ap- 
proaching dissolution; but the first day among some, the 
second day in others, and after several days in many 
cases, a bubo was observed on the lower portion of the 
abdomen, in the groin, or in the folds of the axilla, and 
sometimes back of the ears or on the thighs. 

Some patients were plunged into a condition of pro- 
found drowsiness ; others were victims to furious delirium. 
Those who' were drowsy remained in a passive state, seem- 
ing to have lost all memory of the things of ordinary life. 
If they had any one to nurse them they took food when 
offered from time to time, and if they had no care, soon 
died of inanition. The delirious patients, deprived of 
sleep, were eternally pursued by their hallcinations ; they 
imagined themselves haunted by men ready to slay them, 
and they sought flight from such fancied foes, uttering 
dreadful screams. 

A(S nothing was known of this strange disease, certain 
physicians thought its origin was due tO' some source of 
evil hidden in the buboes, and they accordingly opened 
these glandular bodies. The dissection of the bubo 
showed sub-adjacent carbuncles, Avhose rapid malignity 
brought on sudden death or an illness of but. few days' 
duration. In some instances the entire body was covered 
by black spots the size of a bean. Such unfortunates 
rarely lived a day, and generally expired in an houlr. 
many cases died suddenly, vomiting blood. 

As to treatment, the effects were variable, following 
the condition of the victim. Procopius states that, as a 
fact, no efficacious remedies were discovered that could 
either prevent the onset of the disease or shorten its dura- 
tion. The victims could not tell why they were attacked, 
nor how they were cured. 

The epidemic at Constantinople lasted four months, 
three months of which time it raged with gxeat violence. 
As the epidemic progressed the mortality rate increased 
from day to day, until it reached the point of 5,000 deaths 
per day, and on several occasions ran up to as high as 
10,000 deaths in the twenty-four hours. 

Evagre, the scholastic, another Greek historian of the 



THE GREAT EJt'IDEMICS OF THE MIDDLE AGES. 25 

sixth century, recounts in hs works the story of the 
plague at Constantinople. He states that he frequently 
observed that persons recovering from a. first and- second 
attack subsequently died of a third attack ; also that 
persons flying from an infected locality were often taken 
sick after many days of an incubating period, falling ill 
in their places of refuge in the midst of populations, free, 
up to that time, from the pestilence. 

In following the progress of this epidemic from the 
Orient to the Occident, it was noticed that it always com- 
menced at the sea-ports, and then traveled inland. The 
disease was carried much more easily by ships than it 
could be at the present time, inasmuch as there were no 
quarantines and no pest houses for isolating patients. 
It entered France by the Mediterranean Sea. It was in 
549 that the plague struck Gaul. ''During this time," 
says Gregory of Tours, ''the malady known as the 
inguinal disease ravaged many sections; the province of 
Aries was cruelly depopulated."^ 

This illustrious historian wrote, in another passage: 
"We learned this year that the town of Narbonne was 
devasted by the groin disease, of so deadly a type that 
when one was atacked he generally succumbed. Felix, 
the Bishop of Nantes, was stricken down and appeared to 
be desperately ill. The fever having ceased, the humor 
broke out on his limbs, which were covered with pustules. 
It was after the application of a plaster covered with 
cantharides that his limbs rotted off, and he ceased to live 
in the seventieth year of his age. 

"Before the plague reached Auvergne it had involved 
most all the rest of the country. Here the epidemic at- 
tacked the people in 567, and so great was the mortality 
that it is utterly impossible to give even the approximate 
number of deaths. Populations perished en masse. On 
a single Sunday morning three hundred bodies were 
counted in St. Peter's Chapel, at Clermont, aAvaiting 
funeral service. Death came suddenly; it struck the 
axilla or the groin, forming a sore like a serpent that bit 

^ Georgius Florentinus Gregorius, Historia Francorum, de 417 
a 591 A. D. 



26 HISTORY OF YELLOW FLVER. 

SO cruelly that men rendered up their souls to God on the 
second or third day of the attack, many being so violent 
as to lose their senses. At this time Lyons, Bourges, 
Chalons, and Dijon were almost depopulated by the 
pestilence." 

In 590, the towns of Ayignon and Viviers were cruelly 
ravaged by the Inguinal Disease. 

The plague reached Marseilles, however, in 587, being 
carried there by a merchant vessel from Spain, which 
entered the port as a center of infection. Eight persons 
who bought goods from this trading vessel, and who all 
lived in the same house, were carried off by this plague. 
The spark of the epidemic did not burn very rapidly at 
first, but after a certain time the smouldering fire of the 
pest burst out in a blaze that almost consumed Marseilles. 

Bishop Theodorus isolated himself in a wing of the 
cloister of Saint Victor, with a small number of persons, 
who remained with him during the plague, and in the 
midst of their general desolation continued to implore 
Almighty God for mercy, with fasting until the end of 
the epidemic. After two months of calm, the population 
of the city commenced to drift back, but the plague reap- 
peared anew and most of those who returned died. 

Anglada,^ who derives most of his citations from 
Gregory of Tours, thinks that the plague that devasted 
Strasbourg in 591 Avas only the same inguinal disease that 
ravaged Christendom. He cites, in support of his asser- 
tion, that passage from the historian-poet Kleinlande, 
translated by Dr. Boersch : 

"In 591 there was a great mortality throughout our 
country, so that men fell down dying in the streets, ex- 
piring suddenly in their houses, or even at business. 
When a person sneezed his soul was apt to fiy the body; 
hence the expression on sneezing, ^God hless you/ And 
when a person yawned they made the sign of the cross be- 
fore their mouths." 

Such are the documents we possess on the great 
epidemic of Inguinal Plague of the fourth century, docu- 
ments furnished by historians, to whom medical history 

^Anglada: Etude sur les Maladies Eteintes et les Maladies 
Nouvelles. 



THE GREAT EPIDEMICS OF THE MIDDLE AGES. J7 

is indebted, and not from medical authors, who left no 
records of the pestilences of that period. 

The Black Plague. 

The Black Plague of the fourteenth century was more 
destructive even than the bubonic pest of the sixth 
century, and all other epidemics observed up tO' the 
present day. In the space of four years, more than 
twenty-five millions of human beings perished — one-half 
the population of the world. 

Like all other pestilences, the Black Plague came from 
the Orient — from India, and, perhaps, from China. 
Europe was invaded from East to West, from South to 
North. 

After Constantinople, all the islands and shores of the 
Mediterranean were attacked, and successively became so 
many foci of disease, from which the pestilence radiated 
inland. Constantinople lost two-thirds of its population. 
Cyprus and Cairo counted 15,000 deaths. Florence paid 
an awful tribute to the disease, so great being the mor- 
tality, that the epidemic has often been called Peste de 
Florence. According to Boccacio, 100,000 persons per- 
ished. Venice lost 20,000 victims, Naples 60,000, Sicily 
53,000 and Genoa 40,000. In Rome, the dead were innu- 
merable. 

In Spain, Germany, England, Poland and Russia, the 
malady was as fatal as in Italy. In London they buried 
100,000 persons. It was the same in France. Avignon 
lost 150,000 citizens in seven months, among whom 
(1348) was the beautiful Laura de Noves, immortalized 
by Petrarch. At Marseilles, 56,000 people died in one 
month; at Montpellier, three-quarters of the population, 
including all the physicians, went dcwn in the epidemic. 
Narbonne had 30,000 deaths and Strasbourg 16,000 in the 
first year of the outbreak. 

Paris was not spared. The Chronique de St. Denis in- 
forms us that, '^in the year of Grace 1348, commenced the 
aforesaid mortality in the Realms of France, the same 
lasting about a year and a half, increasing more and more, 
until Paris lost each day 800 inhabitants; so that the 



28 HISTORY OF YELLOW FEVER. 

number who died there amounted to more than 500,000, 
while in the town of St. Denis the number reached 16,000." 

Among the yictims were Jeanne de Bourgogne, wife of 
Philip YI; Jeanne II, Queen of Navarre and grandchild 
of Philip the Beautiful. In Spain, died Alphonso XL, 
of Castille. 

Happily for the human race, during the years which 
followed the plague, the births were greatly in excess of 
the deaths, as though Nature desired to repair the ravages 
wrought by the pestilence. 

According to the records of that time, many persons 
died the first day of their illness. These bad cases were 
announced by a violent fever, with headache, vertigo, 
drowsiness, incoherency in ideas, and loss of memory; 
the tongue and palate were black and browned, exhaling 
an almost insupportable fetidity. Others were attacked 
by violent inflammation of the lungs, with hemorrhage; 
also gangrene, which manifested itself in black spots all 
over the body; if, to the contrary, the body was covered 
by abscesses, the patients seemed to have some chance for 
recovery. 

Medicines were powerless, all remedies seeming to be 
useless. The disease attacked rich and poor indiscrimin- 
ately; it overpowered the robust and debilitated; the 
young and the old were its victims. On the first symptom 
the patients fell into a profound melancholy and seemed 
to abandon all hope of recovery. Ths moral prostration 
aggTavated their physical condition, and mental depres- 
sion hastened the time of death. The fear of contagion 
was so great that but few persons attended the sick. 

The clergy, encouraged by the Pope, visited the bed- 
sides of the dying who bequeathed all their wealth to the 
Church. The plague was considered on all sides as a pun- 
ishment inflicted by God, and it was this idea that in- 
duced armies of penitents to assemble on the public streets 
to do penance for their sins. Men and women went half 
naked along the highways, flagellating each other with 
whips, and, growing desperate with the fall of night, they 
committed scandalous crimes. In certain places the Jews 
were accused of being the authors of the plague by pois- 
oning the wells; hence the Hebrews were prosecuted. 



THE GREAT EPIDEMICS OF THE MIDDLE AGES. 29 

sometimes burned alive by the fanatical sects known as 
Flagellants, Begardes and Turlupins, who were encour- 
aged in their acts of violence by the priests, notwithstand- 
ing the intervention of Clement VI. 

Physicians were not only convinced of the cantagious 
nature of the disease, but also believed that it could be 
transmitted by look and word of mouth. Such doctors 
obliged their patients to cover their eyes and mouth with 
a piece of cloth whenever the priest or physician visited 
the bedside. 

Guillaume de Machant, poet and valet de cliaiiibre of 
Philip the Beautiful, mentions this fact in one of his 
poems : 

■'They did not. dare, in open air 
To even speak by stealth, 
Lest each one's breath might carry death 
By poisoning the other's health." 

And, in the preface of the ''Decameron," Boccacio re- 
marks in his turn : ''The plague communicated direct, as 
fire to combustible matter. They were often attacked 
from simply touching the sick; indeed it was not even 
necessary to touch them. The danger was the same when 
you listened to their words or even if they gazed at you." 

One thing is certain — those who nursed the patients 
surely contracted the disease. 

All the authorities of the Middle Ages concur in their 
statements as to the contagious nature of the plague. 
The rules and regulations enforced against the afflicted 
were barbarous and inhuman. "Persons sick and well, of 
one family, when the pest developed," says Black^, were 
held, without distinction, in close confinement in their 
home, while on the house-door, .a red cross was traced, 
bearing the sad and desperate epitaph : 

Dieu, ayez pitie ne nous!* 

"No one was permitted to leave or enter the plague- 
stricken house, save the physician and nurse, or other 
persons who might be authorized by the Government." 

* Black: Histoire de la Medecine et da la Chirurgie. 

* Lord, have mercy on us! 



30 HISTORY OF YELLOW FEVER. 

We can well judge of the terror inspired by the pestil- 
ence by the precautions which the physicians who attend- 
ed the sick took. In his treatise on the plague, Mauget 
describes the costumes worn by those who approached the 
bedsides of patients : 

''The costumes worn were of Levant morocco, the mask 
haying crystal eyes and a long nose filled with subtle per- 
fumes. The nose was in the form of a snout, with an 
opening on each side. These openings served as respira- 
tory passages and were well-filled at the anterior portion 
with drugs, so that at each breath they contained a medi- 
cated air. Under a cloak, the doctor also wore buskin 
made of morocco; closely-sewed breeches were attached to 
the bottines above the ankles ; the shirt, the hat and the 
gloves were also of soft morocco.'' 

Thus accountered, the doctor resembled a modern diver 
clad in a suit of leather. 

All this sounds ridiculous at the present age, but it 
must be understood that the great epidemics of plague 
were of a nature to terrify ignorant populations. The nar- 
ratives of historians of that epoch show them to be im- 
bued with the superstitious ideas of antiquity. This at- 
tack of an invisible enemy, whose blows fell right and left, 
paralyzed and terrified every one. ''In the midst of this 
orgy of death," remarks Angiada, "the thought of self- 
preservation absorbed every other sentiment. Dominated 
by this selfish instinct the human mind shamelessly dis- 
played its cowardice, egotism and superstition. Social 
ties were rudely sundered, the affections of the heart laid 
aside. The sick were deserted by their relatives; all flew 
with horror from the plague-breathing air and contact 
with the dreadful disease. The corpses of the victims of 
the epidemic, abandoned without sepulture, exhaled a hor- 
ribly putrid odor, and became the starting point of new 
infectious centres. The worse disorder overthrew^ all con- 
ditions of existence. Human passions raged uncontrolled ; 
the voice of authority was no longer respected ; the wheels 
of civilization ceased to revolve." 

LE MAL DES ARDENTS. 

Towards the end of the tenth century a new epidemic 
appeared in Europe, the ravages of which spread terror 



THE GREAT EPIDEMICS OF THE MIDDLE AGES. 31 

among the people of the Occident ; this disease was known 
by the name of Mai des Ardents^ Sacred Fire, St. An- 
thony's Fire, St. MarcelFs Fire, and Hell Fire. 

This great epidemic of the Middle Ages is considered 
by many modern writers as one of the forms of ergotism, 
notwithstanding the contrary conclusions arrived at by 
the Commission of 1776, composed of such men as Jussieu, 
Paulet, Saillant, and Teissier, who were ordered to report 
as to the nature of the disease by the Royal Society. Ac- 
cording to the Avork of this Commission the Mai des Ar- 
dents Avas a variety of plague, Avith buboes, carbuncles 
and petechial spots, while St. Anthony's fire was only 
gangrenous ergotism. This is a remarkable example of 
the confusion into which scientific facts were allowed to 
fall through the fault of careless authors. It is in such 
instances that Ave may estimate the importance of history. 

We find in the ''Chronicles of Frodoard," in the year 
945, the following : 

"The year 945, in the history of Paris and its numerous 
suburban Adllages, a disease called Ignis Plaga attacked 
the limbs of many persons, and consumed them entirely, 
so that death soon finished their sufferings. Some few 
survived, thanks be to the intercession of the Saints; and 
CA^en a considerable number were cured in the Church of 
Notre Dame de Paris.. Some of these, believing them- 
selves out of danger, left the church; but the fires of the 
plague were soon relighted, and they were only saved by 
returning to Notre Dame." 

Sauvel, the translator of Frodoard, remarks that at this 
epoch the Church of Notre Dame served as a hospital for 
the sick attacked by the epidemic, and sometimes con- 
tained as high as six hundred patients. 

Another historian of the time was Raoul Glaber,^ who 
mentions that ''in 993 a murderous malady prevailed 
among men. This was a sort of hidden fire, Ignis Oc- 
cultus, Avhich attacked the limbs i^nd detached them, 
from the trunk after having consumed the members. 

^ The "Chronique de Raoul Glaber," Benedictine of Cluny, 
covers the period between the year 900 and 1046. It 
may be found translated in the collection of memoirs on 
the History of France by Guizot. 



32 HISTORY OF YELLOW FEVER. 

Among some the deToiiring effect of this fire took place in 
a single night.** 

"In 1039," continues onr atithor, "diyine vengeance 
again descended on the human race with fearful effect 
and destroyed many inhabitants of the world, striking 
alike the rich and the poor, the aristocrat and the peasant. 
Many persons lost their limbs and dragged themselves 
around as an example to those who came after them." 

In the Chrouiele of France, from the commencement of 
the Monarchy up to 1029,^ the monk Adhemar speaks of 
the epidemic in the following terms : "In these times a 
pestilential fire [pestilential ignis) attacked the popula- 
tion of Limousin; an infinite number of persons of both 
sexes, were consumed by an invisible fire." 

Michael Felibien, a Benedictinee friar of Saint Maur, 
also left notes on the epidemic of gangTcne. He states 
in his History of Paris : "In the same year, 1129, Paris, 
as the rest of France, was afflicted by the maladie cles 
a relents. This disease, although known from the morality 
it caused in the years 915 and 1011, was all the more ter- 
rible inasmuch as it api^eared to have no remedy. The 
mass of blood, already corrtipted by internal heat which 
devoured the entire body, pushed its fluids outwards into 
ttimors, which degenerated into incurable ulcers and thus 
killed oft' thotisands of people." 

We cotild make many more citations, derived from 
ancient writers, but we think we have quoted enough to 
prove that the Mai des Ardent s was only the plague con- 
founded with the symptoms known as gangrenous ergot- 
ism. Cotild it not have been a i)liigtie of a gangrenous 
type? We cannot positively aflirm, however, that it had 
no connection with poisoning by the sphaceJia developed 
in grain, particularly on rye. Its onset was sudden and 
often very rapidly followed by a fatal termination. 

The Eruptive Fevers of the Sixth Century — Variola, 
Measles, Scarlatina. 

Before the sixth century, the terrible j^eriod of the 
plague, one never heard of the eruptive fevers. Small- 

" Xouvelle Bibiiotheque des Manuscripts. 



THE GREAT EPIDEMICS OF THE MIDDLE AGES. S3 

pox, measles and scarlet fever were unknown to the an- 
cients. Neither Hippocrates nor Galen nor any of the 
Greek physicians Avho practiced in Kome make mention 
of these diseases. The historians and poets of Greece and 
Italy who have written largely on medical subjects remain 
mute on these three great questions in pathology. Some 
authors have endeavored to torture texts for the purpose 
of throwing light on the contagious exanthemata, but 
they have not been repaid for their fresh imagination.'^ 
It is admitted to-day that the eruptive fevers are compara- 
tiveh^ new diseases, which made their appearance in the 
Middle Ages. 

The first document that the history of medicine pos- 
sesses on this point is that left by Marius, Bishop of 
Aventicum, in Switzerland, who says, in his chronicle, 
^^Anno 570, morl>us validus cum profluvio ventris et vari- 
ola, Italiam GaUiamque valde affecit/^^ 

Ten years later, Gregory of Tours described the symp- 
toms of the new disease in the following terms :^ 

''The fifth year of the reign of Childebert, 580, the re- 
gion of Auvergne was inundated by a flood and numerous 
weather disasters, which were followed by a terrible epi- 
demic that invaded the whole of Gaul. Those attacked 
had violent fevers, accompanied by vomiting, great pain 
in the neighborhood of the kidneys, and a heaviness in 
the head and neck. Matter rejected by the stomach looked 
yellowish and even green, many deeming this to be some* 
secret poison. The peasants called the pustules corals.^^ 
Sometimes, after the application of cups to the shoulders 

^ Satirical writers would not have failed to have spoken of the 
marks left by sraall-pox. Such authors as Martial, who 
frequented the public baths in order to write up the 
physical infirmities of his fellow-townsmen, to the end of 
divulging their deformities in biting epigram, would only 
have been too happy to have mocked the faces of con- 
temporaries marked by the cicatrices of small-pox. 

*In the year 570, a violent disease, with running of the belly 
and variola, cruelly afflicted Italy and France. 

® Gregorii Turonensis, Opera Omnia, Liber V. 

^•^ Latin corallum, which signifies heart, lung, intestines, and by 
extension of meaning, the interior of the body. 



$^ HISTORY OF YELIOW FEVER. 

or limbs, blisters were raised, which, when broken, gave 
issue to sanious matter, which oftentimes saved the pa- 
tient. Drinks composed of simples to combat the effects 
of the poison were also very efficacious. 

''This disease, which commenced in the month of Au- 
gust, attacked all the very young children and carried 
them off. 

"In those days Chilperic was also seriously aflaicted, 
and as the King commenced to convalesce his youngest 
son was taken with the malady, and when his extremity 
was perceived he Avas given baptism. Shortly afterwards 
he was better, and his eldest brother, named Chlodobert, 
was attacked in his turn. They placed the prince in a lit- 
ter and carried him to Soissons, in the chapel of Saint 
Medard; there he was placed in contact with the good 
Saint's tomb, and made vows to him for recovery, but, 
very weak and almost without breath, he rendered his 
soul to God in the middle of the night. 

''In those days, Austrechilde, wife of King Gontra, also 
died of the disease ; while Nantin, Count of Angouleme, 
succumbed to the same malady, his body becoming so 
black that it appeared as though calcined charcoal." 

It will thus be seen that smallpox came from the Orient 
— that eternal centre of pestilence and curses. From the 
seventh century the Saracen armies spread the malady 
wherever they passed — in Sja^a, Egypt and Spain: in 
their turn, the Crusaders, in returning from the Holy 
Land, brought the disease into France, England and Ger- 
many; from these foci spread the great epidemics of the 
twelfth and thirteenth centuries, after which smallpox be- 
came periodically epidemic, appearing and disappearing 
without causation, but alwaj^s destroying myriads of vic- 
tims. 

"In 1445," says Sauvel, "from the month of August to 
St. Andre's Day (November 30) over 6,000 infants died 
in Paris from smallpox."^^ The physicians knew neither 
the nature nor the treatment of the disease. 

The measles was first noted at the same time as the 

-^ Sauvel : Histoire et Recherches des Antiquites de la Ville 
de Paris. 



THE GREAT EPIDEMICS OF THE MIDDLE AGES. 35 

small-pox, making its first appearance as an epidemic in 
the sixth century. 

It is more than probable that the measles originated in 
Egypt, and, according to Borsieri, it had such an extension 
throughout Western Europe that there were but few per- 
sons who had not suffered attacks. The history of 
measles, however, is less clearly defined than that of 
small-pox, although Anglada says that it figured among 
the spotted diseases, of which Gregory of Tours speaks. 
But it was only in the sixteenth cCiitury that Prosper 
Martian exactly describes the disease. 

Says Martian, '^It is a disease of a special type, peculiar 
to children. It commences with a yiolent fever, followed, 
towards the third day, by an eruption of small red spots, 
which become elevated by degrees, making the skin feel 
rough to the touch. The fever lasts until the fifth day, 
and when it has ceased, the papules commence to disap- 
pear.-' 

Measles was designated in the middle ages under the 
name MorhiUi, which signified a petty plague, the same 
that Morbus meant a special plague. It is then fair to 
presume that the type of disease was no more serious than 
it is at the present day. 

It is probable that the measles of the sixth century in- 
cluded at the same time small-pox, measles and scarlet 
fever, of which the ancients made no differential diag- 
nosis. Anglada affirms the co-existence of all forms of 
eruptive fevers and gives the following reasons : 

''The contemporaneous appearance of variola and rube- 
ola represents the first manifestation of an epidemic con- 
stitution, resulting from a collection of unknown influ- 
ences as to their nature, but manifest by their effects. 
The earth was thence prepared to receive scarlatina, 
and it soon came to bear its baleful fruits. We do meet 
some mention of scarlet fever in the writings of the Ara- 
bian School, but it is merely suspected and only vaguely 
indicated. But when we remember how difficult it often 
is to diagnose at first between variola and measles, we are 
not astonished at the indecision manifested in adding an- 
other exanthematous affection to the medical incognito. 
It was onlv after innumerable observations and the ex- 



36 HISTORY OF YELLOW FEVER. 

perience of several centuries that the third new disease 
received its nosological baptism. There is nothing to 
prove that it did not co-operate with earlier epidemics of 
variola and rubeola, remaining undistinguished as to 
type, however." 

What clearly proves that there was confusion between 
the various fevers of exanthemata is that Ingrassias de- 
scribes scarlatina in 1510, under the name of rosaUia, add- 
ing, "Some think the measles and rosaUia are the same 
malady; as for me, I have determined their differences on 
many occasions.'' 

These facts appear conclusive enough to admit that 
measles and scarlet fever are,, like variola, the products 
cf the epidemic constitution developed during the sixth 
century, as contemporaries of the bubonic plague, all these 
maladies representing the medical constitution of the 
first centuries of the Middle Ases. 



"»' 



The Sweating SickxeSc. 

The name of Sweating Sickness was given to the gTcat 
epidemic of fever that appeared in England in the 
fifteenth century, and thence extended over Continental 
Europe. This ej)idemic broke out in the month of Septem- 
ber, 1186, in the army of Henry YIL, encamped in Wales, 
and soon reached London, extending over the British Isles 
with frightful rapidity. Its appearance was alarming 
and while it lasted, which was only a month, it made 
a considerable number of victims. ^'It was so terrible 
and so acute that within the memory of man none had 
seen its like." 

This epidemic reappeared in England in 1513, 1517, and 
1551. It was preceded by very moist weather and violent 
winds. The mortality was great, patients often dying in 
the space of two hours ; in some instances half the popula- 
tion of a town being carried off. The epidemic of 1529 
was surely murderous; King Henry VIII was attacked 
and narrowly escaped death. Although flying from vil- 
lage to village the nobility of England paid an enormous 
tribute to the King of Terrors. The Ambassador from 
France to London, L. du Bellay, writing on the 21st of 



THE GREAT EPIDEMICS OF THE MIDDLE AGES. Si 

July, 1529, remarks: ''The day I visited the Bishop of 
Canterbury eighteen of the household died in a few 
hours. I was about the only one left to tell the tale, and 
am far from recovered 3^et." 

This same year the sweating sickness spread all over 
Europe. It made terrible ravages in Holland, Germany, 
and Poland. At the famous synod of Luther and 
Zwingie, held at Marburg, the Reformed ministers seized 
by fear of death prayed for relief from the pestilence. At 
Augusburg in three months eighteen thousand people were 
attacked and fourteen hundred died. 

This epidemic did not extend as far as Paris, but it de- 
veloped in the north of France and Belgium. 

Fernel, physician to Henry II., who practiced in Paris, 
likewise speaks- of this sudorific sickness in one of his 
works. ^^ 

It prevailed generally in summer and autumn, especial- 
ly when the weather was moist and foggy. Contrary to 
what is seen in other epidemics, it was observed that the 
weak and poor and the old and infants were not attacked 
as often as robust persons and those in affluent circum- 
stances. 

The symptoms noted hj physicians, such as Kaye and 
Bacon, may be classed into three distinct periods : 

1. The period of chill, characterized by pains and 
itching in the limbs, an extraordinary prostration of the 
physical forces — a tremulous, shaky period. 

2. The period of sweat, preceded by a burning heat all 
over the body and an unquenchable feverish thirst. The 
patient was agitated, disquieted b}^ terror and despair. 
Many complained of spasms in the stomach, followed 
sometimes by nausea and vomiting, suffocation and lum- 
bar pains, headache, with palpitation of the heart and 
proecardial anxiety. This period was announced by a 
high delirium, sometimes muttering, sometimes loqua- 
cious; a fetid sweaty odor, irregular pulse, coma, and, in 
the last named condition, death always occured. 

3. The duration of the disease was most frequently but 
a few hours, rarely exceedingly a day, whether the termin- 
ation was favorable or fatal. 

'- Ferneli : Universa Medico 



S8 HISTORY OF YELLOW FEVER. 

Convalescence was always long, often being complicated 
by diarrhoea or dropsy. It has been remarked in this con- 
nection that the malady might be confounded with the 
miliary sweat observed in Picardy and central France, 
but in the first named disease no cutaneous eruption was 
observed. Fernel clearly affirms this statement, as he 
says: ''In this affection there is no carbuncle, bubo, ex- 
anthema or eczema, but simply a hypersecretion of 
sweat." 

Such was the sweating sickness of the sixteenth cen- 
tury, which made so few victims in France, but which de- 
stroyed so many people in England and Germany.^^ The 
origin of this disease has been often discussed, and also 
its nature ; but all theories expounded by various authors 
partake of the doctrines of other days and are too anti- 
quated to be revamped. 

The Scurvy. 

It has been supposed by many that Hippocrates de- 
scribed scurvy under the name of Enlarged Spleen, an af- 
fection attributed to the use of stagnant water and char- 
acterized by tumefaction of the gums, foul breath, pale 
face, and ulceration of the lower limbs. But the study of 
the Hippocratic passage leads us to think that these symp- 
toms were more of the character of scrofula than of 
scurvy. The recital by Pliny of the disease of the Eoman 
soldiers while on an expedition to Germany seems to in- 
dicate scurvy, which Coelius Aurelianus, and after him 
the Arabian physicians, claims presented only a slight 
analogy to that affection. 

Springer thinks that we may find the first traces of 
scurvy in the expedition of the Normans to Wineland, in 

^^ According to the Climatologist, vol. 1, p. 63, 1888, the "Sweat- 
ing Sickness" appeared in epidemic form in 1887. It 
broke out in the Department of Vienne, Haute Vienne, 
in March of that year. The French Government prompt- 
ly sent .a commission of prominent sanitarions, with Prof. 
Brouardel at their head, into the infected districts, with 
power to take measures for the restriction of the disease. 
Strict isolation and disinfection soon brought the out- 
break to an end. — G. A, 



THE GREAT EPIDEMICS OF THE MIDDLE AGES. 39 

the first years of the eleventh century. In admitting that 
the men commanded by Eric Thorstein were obliged to 
winter on the western shores of Wineland and almost all 
succombed to an epidemic malady of that country, proves 
that it Avas nothing but scurvy, although the word's only 
signification, in Danish, is ulceration of the mouth. 

We have, besides, another document, which has great 
authentic value, a proof transmitted to us by our earliest 
and best chronicler of the Middle Ages, Joinville, the 
friend and companion of Saint Louis in his Crusade into 
Palestine. In his memoirs he gives a very succinct re- 
cital of the epidemic of famine and scurvy which attacked 
the French army on the banks of the Nile in 1248, just 
after the battles of Mansourah.^^ 

The relation of Joinville leaves no doubt as to the na- 
ture of the epidemic that attacked the Crusaders. He 
gives a minute pen picture of the debility, and hem- 
orrhages, the livid ecchymosis of the skin, the fungous 
tumefaction and bleeding of the gums, which character- 
ize the disease known as scurvy. 

According to the writings of some German physicians 
of the fifteenth century, this malady was endemic in the 
septentrional portions of Europe upon the shores of the 
Baltic Sea. In Holland numerous epidemics of scurvy 
were observed among the lower classes of the population, 
coinciding with bad conditions of public hygiene, such as 
food consisting of salt and smoked meats, dwellings lo- 
cated on marshy ground, cold atmospheres charged with 
fogs, etc. 

This was the same infection that attacked our colonies 
in Canada, but at that time we had no knowledge of the 
therapeutic indications in such emergencies. A proof of 
this remarkable observation is inscribed on the registers 
of Cartier on his vessels during his sojourn in Canada. ^^ 

Leprosy. 

Leprosy is a disease originating in the Orient; Egypt 
and Judea were formerly the principal infected centres. 

^* Joinville: Histoire de Saint Louis. 

^'Cartier: Bref Recit et Succincte Narration de la Navigation 
Faite aux Ysles de Canada. Paris, 1545. 



40 HISTORY OF YELLOW FEVER. 

It was the return of an expedition to Palestine, under 
Ponipey, that imported the malady to Italy. In the first 
years of the Christian Era it is mentioned by Celsus, who 
advised that it should be treated by sweating, aided by 
vapor baths. Some years later Areteus used hellebore, 
sulphur baths, and the flesh of vipers taken as food, a 
treatment adopted by others, as, for instance, Musa and 
Archigenes. 

In the second century the disease was in Gaul ; Soranus 
treated the lepers of Aquitaine, who were numerous. ^^ 

According to Yelley, leprosy was common in France in 
the middle of the eighth century, when Nicholas, Abbot 
of Corbeil. constructed a leper hospital, which was never 
much frequented until after the Crusades of the eleventh 
and fctirteenth centuries. At this period the number of 
lepers, or lad res, a name given to the unfortunates in re- 
membrance of their patron saint, St. Lazarus, became so 
gTeat that every town and village was obliged to build a 
leper house in order to isolate the afflicted. Under Louis 
VIII. there were 2,000 of these hosiDitals; later the num- 
ber of such asylums reached 19,000. 

According to the historians of this time, when a man 
was suspected to be a leper he cotild have no social rela- 
tions without making full declaration as to what the real 
nature of his complaint might be. Without this j)recau- 
tion his acts were void, from the caxDitiilary of Pepin, 
which dissolved all marriage contracts with lepers, to the 
law of Charlemagne, that forbade their associating with 
healthy persons. The fear of contagion was such that in 
places where no leprosy existed they built small houses 
for any one who might be attacked ; these houses were 
called fto/r/ev.^" A gray mantle, a hat and wallet, were 

^^^ Gregory of Tours says that in Paris they had a place ol 
reiuge, where they cleaned their bodies and dressed 
their sores 

" Tbey designated by the name of borde, bordeau, bordell, 
bordette, bourde, or boiirdeau, a small house or cabin 
built on the edge of town; a cabin intended to contain 
lepers. The word bordell. a house of ill-fame, as used 
even in modern days, takes its origin from borde, an 
asylum for lepers 



THE GREAT EPIDEMICS OF THE MIDDLE AGES. 41 

also supplied the victims, also a tartarelle, a species of 
rattle, or a small bell, with which they warned all passers 
near not to approach. They also had a cup placed on the 
far side of the road, in which all persons might drop alms 
without going near the leper. 

Leper houses were enriched, little by little, by the liber- 
ality of kings and nobles and the people, and to be a 
leper became less inhuman and horrible than at the be- 
ginning. 

After entering a leper house the victim was considered 
as dead under the civil law, and in order to make the pa- 
tients better understand their position the clergy accom- 
panied them to their asjdum, the same as to their funeral, 
throwing the cemetery dust on them while saying: '^En- 
ter no house save your asylum. When you speak to an 
outsider, stand to the windward. When you ask alms, 
sound your rattle. . You must not go far from the asylum 
without your leper's robe. You must drink from no well 
or spring save on your own grounds. You must pass no 
plates or cups without first putting on your gloves. You 
must not go barefofted, nor walk in narrow streets, nor 
lean against Avails, trees, or doors, nor sleep on the edge 
of the road," etc. 

When dead they were interred in the lepers' cemetery 
by their fellow-sufferers. 

It is true that each time that sanitary measures were 
relaxed by the authorities — such, for instance, as the per- 
fect isolation of the patients — an increase in the number 
of lepers was noticeable. When this was observed the 
old-time ordinances were enforced again with vigor. It 
was thus in 1371 the Provost of Paris issued an edict 
enjoining the lepers to leave the Capital within fifteen 
days, under heavy corporal and pecuniary penalties; and 
in. 1388, all lepers were forbidden to enter Paris without 
special permission; in 1402 this restriction was renewed, 
^'under penalty of being taken \)j the executioner and his 
deputies and detained for a month on a diet of bread and 
water, and afterwards perpetual banishment from the 
kingdom." Finally, in April, 1488, it was announced ^^all 
persons attacked by that abominable, very dangerous and 
contagious malady known as leprosy, must leave Paris 



42 HISTORY OF YELLOW FEVER. 

before Easter and retire to their hospitals from the date 
of issuance of this edict, under penalty of imprisonment 
for a month on bread and water ; and, where they had 
property, the sequestration of their houses and jewels and 
arbitrary corporal punishment; it was permitted them, 
howeyer, to send things to them by servants, the latter 
being in health." 

We can understand from this how these poor wretches, 
at different epochs, were accused of horrible crimes, among 
other things, poisoning rivers, wells, and fountains. As 
regards this accusation, says the author of the Distion- 
naire des Moeurs des Francais^ Philip le Long burned a 
certain number of these poor wretches at the stake and 
confiscated their wealth, giving it to the Order of Malta 
and St. Lazare. 

A minute description of this disease will be found in the 
works of Barbarin.^^ 

The physicians of leper hospitals have left behind a 
great number of medical documents bearing on the char- 
acteristics of the disease, but their observations are so 
confused that we can only conclude that they considered 
all cutaneous maladies as belonging to the same constitu- 
tional vice. 

In 1543, leprosy was so widespread in France, as to be 
beyond sanitary control, and the edict of Francois I., re- 
establishing leper hospitals, amounted to nothing. There 
were too many affected people. The Hospital of Lour- 
cine, which was sf»ecially devoted to these cases at Paris, 
contained 600 patients in 1540, and in the wards of 
Trinity Hospital and the Hotel Dieu there were many 
more. It was the same in the Provinces, notably at Tou- 
louse, which had the merit of creating the first hospital 
of its kind ever instituted. Finally, fifty years later, in 
1606, for want of lepers, the leper asylums were offlcially 

^'^ Etienne Barbazin, erudite and historian, born in 1696, author 
of a number of works on the History of France: "Recueil 
Alphabetique de Pieces Historiques"; "Tableaux et 
Contes Francais, des XII., XIIL, XIV., et XV., Siecles"; 
"The Orders of Chivalry, etc." He also left numerous 
manuscripts on the origin of the French language. See 
"Bibliotheque de TArsenal." 



THE GREAT EPIDEMICS OF THE MIDDLE AGES. 43 

closed. Henry IV., in a proclamation, gave those remain- 
ing ''to poor gentlemen and crippled soldiers." 

Thus ended the epidemic of leprosy in France, which 
had prevailed from the second century, observing the 
same progress in other countries of Western Europe dur- 
ing the same period of time. 



CHAPTEK lY. 

INSECTS AS PROPAGATORS OF DISEASE. 

How Pestilence is Spread by Flies, Mosquitoes, Fleas and Other 

Insects. — Instances Where Disease Was Conveyed by Bed-Bugs and 

Ants. — The Role played by the Cattle-Tick and the Tsetse-Fly. — Sum- 
marj' of the Mosquito Doctrine. — Bibliography. 

In the medical part of this Tolume will be found a de- 
tailed scientific account of the mosquito theory. For the 
benefit of the lay reader, however, who is either too busy 
to digest the riews expressed in these instructive observa- 
tions, or who does not care to tussle with medical phrase- 
olooy, we will give a short talk regarding the role played 
by insects in the propagation of disease. 

There is no novelty in the doctrine of insect or animal- 
cular origin of disease. Many of the older writers, most 
conspicuous amongst whom are Linnaeus, Kircher and 
Lyander, have promulgated such an opinion, and it has 
been vaguely presented to the notice of the medical pro- 
fession in the past ; but it was not until after the publica- 
tion of Ebrenberg's great work on Infusoria (1838) that 
its bearings were fully appreciated. 

It will no doubt be ncAvs to many to learn that the mos- 
quito theory of the transmission of yellow fever came 
very nearly being expounded over half a century ago. Dr. 
Xott, of Mobile, in a paper published in 1848,^ reviews the 
situation in a scholarly manner and attributes the speci- 
fic cause of yellow fever to ''some form of insect life." He 
does not mention the mosquito as the active agent of 
transmission, but, in a long and carefully-prepared paper, 
dwells upon the fact that "certain insects'' are capable of 
transmitting the disease. 

Among other things. Dr. 'Nott makes the following as- 
sertion (loc. cit. p. 40), which certainly is prophetic of 
the theory fathered by Dr. Finlay: 

"It would certainly be quite as philosophical (as the 
malarial theory) to suppose that some insect or an animal- 
cule, hatched in the lowlands, like the mosquito,- after 

^Nott: New Orleans Medical and Surgical Journal. 1848, vol. 

4, p. 563. 
- The emphasy is ours. G. A. 



INSECTS AS PROPAGATORS OF DISEASE. 45 

passing- through its metamorphoses, takes flight, and 
either by preference for a different atmosphere, or im- 
pelled by one of those extraordinary instincts which many 
are known to possess, wings its way to the hill top to ful- 
fil its appointed destiny." 

Twenty-two years later (1870), Dr. Nott was commis- 
sioned by the Board of Health of the City of New York to 
prepare and present to the Board a report upon the out- 
break of yellow fever at Governor's Island that year. In 
an elaborate paper, in which thie Doctor touches upon the 
causes of the outbreak and its progress, he comments at 
length upon the insect hypothesis. The following extract 
from Dr. Nott's paper is the nearest approach to the pres- 
ent accepted doctrine of transmission we have yet seen 
in opinions of the past :^ 

"It is possible," observes Dr. Nott, ''that even insects 
may exist a million times smaller than any the microscope 
has yet reached. While the slow and steady progression 
of yellow fever from a point, as I have described it, should 
be received as an indis]3utable fact, on the other hand we 
confess that the fact is at present inexplicable ; it must be 
some form of living organism, Avhich multiplies and ex- 
tends by organic laws. If in insects form, it is easy to 
understand its progress, and, if a fungus, we are not with- 
out examples in the larger fungi, of a manner of progres- 
sion from a given spot more rapid than that of yellow 
fever. Moreover, it is the business of some insects to dis- 
tribute certain seeds of plants far and wide ; to carry the 
pollen of one plant to another to fructify it; and it may 
be the duty of others to disseminate diseases. It is well 
known, on the authority of Murchison and others, that 
the malignant pustule is taken by gnats from the animal 
and communicated to man by its bite. So there are many 
ways that diseases might be carried and communicated by 
insects or fungi. 

"I will here mention a fact which I have often noticed 
myself with regard to mosquitoes/ but have never seen it 
alluded to by others. These insects are so abundant in 

'Nott: Annual Report of the Board of Health of the Health 

Department of the City of New York, 1870, p. 363. 
*The emphasy is ours. G. A. 



46 HISTORY OF YELLOW FEVER. 

Mobile, New Orleans, and other Southern cities, that it is 
impossible to sleep at night without the j)rotection of mos- 
quito nets. Fair-skinned persons from more northern 
climates, and particularly Toung children recently intro- 
duced, suffer greatly from the bites of this insect, the bites 
often inflaming, and even making tedious, troublesome 
sores; whereas the children of i^arents who have lived a 
generation or two in the climate suffer comi3aratiTely 
little; they seem to become acclimatized against the 
poison of these insects as they do against the i)oison of 
yellow fever. On rising from my own bed in the morning 
I have many times seen my little children lying in a trun- 
dle-bed covered by mosquitoes, after, as Mrs. Jackson said, 
'kicking the kiver off.' The insects had been biting at 
them for hours, and yet by breakfast-time every mark had 
disappeared. Such would not be the case with children of 
fair-skinned i3arents recently brought into the clime. 
Some Southern children, it is true, are more susceptible 
to the i^oison of mosquitoes than others, and so it is with 
regard to suscej)tibility to yellow fever." 

If Dr. Nott had simj)ly gone a little further and directly 
accused the mosquito of being the active agent of trans- 
mission, yellow fever would have been eradicated from the 
American Continent years ago and the illustrious South- 
erner would have occupied a place in the annals of fame 
which would have endured for all time to come. 

Tiktine, in an article entitled '^'Contagion through the 
Infltience of Insects,"'^ relates facts of great interest. In 
a review of this j)aper made in the Bulletin of the Pasteur 
Institute for April, 1897, mention is made of an epidemic 
of relapsing fever which occurred in Odessa, Russia, 
where the disease is almost unknown.^' It seems that a 
sailor who came from Jaffa was suffering from this mal- 
ady and was admitted to the hospital. A week later an- 
other patient was admitted, and soon after a tremendous 
epidemic occurred, which affected more than ten thousand 
individuals. Most of these were sailors, living about the 
harbor, who ustially applied for admission after a de- 

= Bulletin Medical (Paris), Februarj^ 3, 1S97. 
^ This disease is exceedingly rare in the United States, but is 
quite prevalent in Great Britain. 



INSECTS AS PROPAGATORS OF DISEASE. 4? 

bauch. Dr. Tiktine went to see a number of them, and 
was struck by the enormous number of bed-bugs, lice and 
fleas with Avhich they were covered. He then thought that 
the contagion might have arisen from these parasites 
going from one indiyidual to the other. One of these in- 
sects, passing from a sick man to a healthy one, might 
inoculate the latter hj its sting, still smeared with blood, 
or else the sleeper, abrading his skin by scratching, might 
become infected by crushing the parasite, full of septic 
blood, over the sore places. 

The Doctor collected some bed-bugs and allowed them 
to fast, after Avhicli he placed them upon the skin of pa- 
tients suffer ino- from an attack of relapsing fever. They 
rapidlv filled themselves with blood which, upon micro- 
scropic examination, was found to contain large numbers 
of spirilli s^^■'ll in motion. He was able to show that their 
vitality persisted, wiinin the insect, for more than 
eighteen hrurs. Besides this, bed-bu,2S were fed upon the 
blood of a monkey that had been inoculated with spiril- 
lum fever. They were then placed upon a health}^ monkey, 
and the latter soon had a characteristic attack of the dis- 
ease. 

''We can therefore see what a preponderating place is 
taken by insects in the spreading of contagious diseases," 
concludes the reviewer. ''We knoAv that flies often carry 
about the bacilli of tuberculosis, of cholera, of purulent 
ophthalmia, and of anthrax. Finlay of Havana, believes 
that flies are the principal agents in the dissemination of 
yellow fever, and Hammond shares this view. Texas 
fever, according to Smith and Kilborne, is propagated by 
ticks which spread about a hgematozoa, belonging, like 
that of the malarial infection, to the class of protozoa." 

Howard, whose great work on the natural life of the 
mosquito is a standard, thus describes how typhoid fever 
is propagated by the common house-fly -J 

"The principal insect agent in this spread is the com 
mon house fly and this insect is especially abundant in 
country houses in the vicinity of stables in which horses 
are kept. The reason for this is that the preferred food of 

^Howard: Farmers' Bulletin No. 155, U. S. Department of 
Agriculture, 1902, p. 12. 



48 HISTORY OF YELLOW FEVER. 

tlie larvae of house flies is horse manure. House flies 
breed in incredible numbers in a manure pile largely de- 
rived from horses. Twelve hundred house flies, and per- 
haps more, will issue from a pound of horse manure. Ten 
days completes a generation of house flies in the summer. 
The number of eggs laid by each female fly averages 120. 
Thus, under favorable conditions, the offspring of a single 
over- wintering house fly may in the course of a summer 
reach a flgure almost beyond belief. With an uncared-for 
pile of horse manure in the vicinity of a house, therefore, 
flies are sure to swarm. Their number practically Avill 
be limited only by breeding opportunities. They are at- 
tracted to, and will lay their eggs in, human excrement. 
Under favorable conditions they will breed, to some ex- 
tent, in this excrement. They swarm in kitchens and 
dining rooms where food supplies are exposed. They are 
found commonly in box privies, which sometimes are not 
distant from the kitchens and dining rooms. Therefore, 
with an abundance of flies, with a box privy near by, or 
with excremental desposit in the neighborhood, and with 
a perhaps unsuspected or not yet fully developed case of 
typhoid in the immediate neighborhood, there is no reason 
why, through the agency of contaminated flies alighting 
upon food supplies, the disease should not be spread to 
healthy individuals. That it is so spread is not to be 
questioned. That under the unusual conditions of the 
army concentration camps in the summer of 1898 it was 
so spread to a shocking extent has been demonstrated by 
the army typhoid fever commission. And the remedy is 
plain. It consists of two courses of procedure: (1) Pro- 
per care of excereta; (2) the destruction of flies." 

The same authority says,^ that while in malaria and 
typhoid we have the two princii)al diseases common to the 
United States which may be conveyed by insects, the 
agency of these little creatures in the transfer of disease 
germs is much more widespread in warm countries, and it 
is by no means confined to human beings. In Egypt and 
in the Fiji Islands there is a destructive eye disease of 
human beings the germs of which are carried by the com- 

«Loc. cit., p. 17. 



INSECTS AS PROPAGATORS OF DISEASE. 49 

mon house fly. In our Southern States an eye disease 
knoAvn as pink-eye is carried by certain very minute flies 
of the genus Hippelates. In certain tropical countries a 
disease known as filariasis, which somewhat resembles cer- 
tain forms of leprosy, is transferred among human beings 
by certain mosquitoes. There is good reason to suppose 
that the germs of the bubonic plague may be transferred 
from sick people to healthy people by the bites of fleas. 
The so-called Texas fever of cattle is unquestionably 
transferred by the common cattle tick and this was the 
earliest of the clearly demonstrated cases of the transfer 
of disease by insects. In A^frica a similar disease of cattle 
is trasferred by the bite of the famous biting fly known as 
the tsetse fly. The germs of the disease of cattle known as 
anthrax are carried by gadflies, or horse flies, and when 
these flies subsequently bite human beings malignant pus- 
tules may result; and other discoveries of this nature are 
constantly being made. Even the common bedbug is 
strongly suspected in this connection. 

Jelliffe, in speaking of flies as carriers of disease, gives 
the following example :^ 

To prove that flies as well as men and animals were able 
to contract the plague, a certain number of insects were 
allowed to feed on the crushed organs of an animal that 
had died of it, while an equal number of flies were fed 
on similar organs of a healthy animal. In several repeti- 
tions of this experiment all the infected flies were dead at 
the end of six or seven days, while nearly all the other flies 
were alive. All the dead flies had the living germs of the 
plague in their intestines. In plague stricken countries 
where there are no sewers, no garbage laws, and no sani- 
tation, where dead animals lie unburied, where families 
live and eat and sleep in the same room, it is logical to 
conclude that the flies, the only natural scavengers, should 
become infected, and should, in the few days that elapse 
before they die, infect all the food they light on. 

The following experiment is also related by Jeliffe: 

''Flies are not the only insects that carry the plague. 
Ants and fleas are just as dangerous. In India, when a 

» Jeliffe: Munsey's Magazine, 1901, Vol. 25, p. 707. 



50 HISTORY OF YELLOW FEVER. 

rat dies of the jjlagiie. Ms body is promptly eaten by ants. 
To i)rove that the insects contract the infection, an exj^eri- 
nienter dipped the point of a needle in their excreta, and 
with it x^ricked some living rats and mice, which he kei:)t 
carefully in cages. They in turn died of the j)lagne. 
That such a slight thing as a pin prick is enough to allow 
the germs to enter the body of a human being is shown by 
the case of the two Jax^anese physicians who scratched 
themselres with the jjoints of their instruments while 
making autopsies on plague patients^ and immediately 
took the disease.-' 

It will thus be seen that not only flies and mosquitoes, 
but **all insects that bite" should be looked uj)on with sus- 
picion and destroyed. 

The earliest reference to mosquitoes in connection with 
yellow fever that we have been able to discover, is made 
by Benjamin Bush in his Medical Itiqniries and 0]bserva- 
tions. I Vol. 5, p. IS I, edition of 179S. In speaking of the 
yellow fever epidemic at Philadelphia in 1797, he says : 

"In addition to the register of the weather, it may not 
be improper to add, that mosquitoes were more numerous 
during the prevalence of the fever than in 1793. An un- 
usual number of ants and cockroaches were also observed : 
and it was said that the martins and swallows disap- 
peared from the city an<;l its neighborhood." 

The presence of mosquitoes during the prevalence of 
yellow fever was also noted by an early wi^iter. Dr. John 
Vaughan,^'^ in his observations on the epidemic at Wil- 
mington. Delaware, in 1S02. ''Myriads of mosquitoes,'' 
says this wiiter, "infested the lower parts of the town 
from July until frost, having gradually diffused them- 
selves over the borough in September. The eldest of our 
inhabitants do not recollect this insect being so trouble- 
some here in any previous season: while the unanimous 
report of persons from the fenny counties of Kent and 
Su>?sex. the annual haunts of these winged pests, was that 
they were unusually free from them." 

It is also worthy of note that the fever did not spread 
'^Vaughan: Medical Repository, X. Y., 1803, vol. 6, p. 299. 



INSECTS AS PROPAGATORS OF DISEASE. 51 

to Kent and Sussex counties, but spent all its virulence 
in the district where the mosquito was more abundant. ^^ 

The idea that yellow fever could be transmitted by mos- 
quitoes originated with Dr. Carlos Finlay, of Havana, in 
1881. The doctor noticed a correspondence between the 
abundance of mosquitoes and a period of increase of yel- 
low fever in the autumn, while during the summer yellow 
fever had not prevailed to any extent and mosquitoes had 
also been less numerous. This set the doctor to thinking 
and a suspicion lurked in his mind that these pestiferous 
insects were probably responsible for the spread of the 
dsease. He immediately began a series of experiments, 
which resulted in the great discovery which has revodu- 
tionized the antiquated theories concerning the propaga- 
tion of yellow fever and which are detailed in the medical 
part of this volume. 

We will end this summary by giving the conclusions of 
Reed, Carroll and Agramonte, taken from their mas^terly 
essay on the etiology of yellow fever, which sums up the 
whole situation in a nutshell '}^ 

1. The mosquito^ — C. fasciatus — serves as the inter- 
mediate host for the parasite of yellow fever. 

2. Yellow^ fever is transmitted to the non-immune in- 
dividual by means of the bite of the mosquito that has pre- 
viously fed on the blood of those sick with this disease. 

3. An interval of about twelve days or more after con- 
tamination appears to be necessary before the mosquito is 
capable of conveying the infection. 

4. The bite of the mosquito at an earlier period after 
contamination does not appear to confer any immunity 
against a subsequent attack. 

5. Yellow fever can also be experimentally produced 
by the subcutaneous injection of blood taken from the 
general circulation during the first and second days of 
this disease. 

6. An attack of yellow fever, produced by the bite of 
the mosquito, confers immunity against the subsequent 

" See Chapter on "Yellow Fever in Maine," in this volume, 
^ The Etiology of Yellow Fever, By Walter Reed, James 
Carroll and Aristides Agramonte, 1901. 



52 HISTORY OF YELLOW FEVER. 

injection of the blood of an individual suffering from the 
non-experimental form of this disease. 

7. The period of-^incubation in thirteen cases of ex- 
perimental yellow fever has varied from forty-one hours , 
to ^Ye days and seventeen hours. 

8. Yellow fever is not conveyed by fomites, and hence 
disinfection of articles of clothing, bedding, or merchan- 
dise, supposedly contaminated by contact with those sick 
with this disease, is unnecessary. 

9. A house may be said to be infected with yellow^ fever 
only Avhen there are present within its walls contamin- 
ated mosquitoes capable of conveying the parasite of this 
disease. 

10. The spread of yellow fever can be most effectually 
controlled by measures directed to the destruction of mos- 
quitoes and the protection of the sick against the bites of 
these insects. 

11. While the mode of propagation of yellow fever has 
now been definitely determined, the specific cause of this 
disease remains to be discovered. 

BIBLIOGRAPHY ON TRANSMISSION Or OISP^ASE BY INS»=CTS. 

NOTE BY THE AUTHOR. 

As this work treats principally of yellow fpver, we give below only 
a partial bibliography of the transmissioT» of disease by insects. The 
literature on the relation between the transmission of malaria and 
the mosquito is enormous and can be foupd in the Index Medicus, 
the Index Catalogue of the Surgeon-H ''nopal's Office and medical 
journals. 

The bibliography of the transmissio '^ c* yellow fever by the mos- 
quito will be found in another part c* t] '-^x volume. 

BOOKS AND MO>TOaRAPHS. 

CORNOLDI (G. M.). La Mosca et il Colera. (Octavo.) Venice 

1884. 

HOAVARD (L. O.). How insects affect health in rural districts. 
U. S, Dept. of Agriculture: Farmers' Bulletin No. 155, 1902. 

HEISE (J. G.). De insectorum noxio effectu in corpus humanunL 
Halae Magdeb., 1757. 



INSECTS AS PROPAGATORS OF DISEASE. 53 

JOLY (R. A. P.). Importance du role des insectes dans la trans- 
mission des maladies infectieuses et parasitaires. Du formol comme 
insecticide. (Octavo.) Bordeaux, 1898. Also Abstract. 

LAVERAN (A,). Traite du Paladisme. (Octavo.) Paris, 1898. 
(See pages 123; 129.) 

LEVRIER. (Translation into French of Nuttall's work below cited.) 
2 vols. (Octavo.) Bordeaux, 1900. 

MUHLING (P.). Die Uebertragung von Krankheitserregern durch 
Wanze und Blutegel. (Octavo.) Konigsberg, i. p., 1899. 

NUTTALL (G. H. F.). On the role of insects, arachnids, and 
myriapods as carriers in the spread of bacterial and parasitic diseases 
of man and animals; a critical and historical study.. (Octavo.) Balti- 
more (no date). 

JOURNALS. 

ABEL (R.). Einige Fraganzungen zu der in No. 5-12 dieser Zeit- 
schrift Erschienenen Abhandlung von Nuttal uber die Rolle der In- 
sekten u. se. w. bei der, etc. Thiere. Hyg. Rundschau, Berl., 1899, Vol. 
9, p. 1065.. 

ANOTHER tick-borne disease. Interstate M. J., St. Louis, 1902, 
Vol. 9, p. 443. 

BASTIANELLI (G.) and BIGNAMI (A.). Sullo sviluppo del para- 
sitti della ternaza nell' Anopheles claviger. Bull. d. r. Acad Med. di 
Roma, 1899, vol. 25, p. 277. 

Ibid. Ann. d'Ig. Sper., Rome, 1899, vol. 9, p, 272. 

Ibid. Malaria and Mosquitoes. Lancet, London, 1900, vol. 1, p. 79. 

(See also other articles by the above authors, published in European 
medical journals from 1896 to 1900.) 

BEACH (C. C). Insects as etiological factors in disease. Proc. 
Connect. M. Soc, Bridgeport, Conn., 1899, p. 95. 

BEALE (A.). Cholera, a fly-borne disease. Indian M. Rec, Cal- 
cutta, 1897, Vol. 12, 76. 

BRENNAN (T.). La mouche comme agent de propagation des 
maladies et comme milieu de metamorphose microbienne. Rev. med. 
du Canada, Montreal, 1902-3, Vol. 6, p. 33. 



54 HISTORY OF YELLOW FEVSR. 

BUCHANAN (W. J.). Cholera diffusion by flies. Indian M. Gaz., 
Calcutta, 1897, Vol. 32, p. 86. Also: Dietet. & Hyg. Gaz., N. Y,. 1897, 
Vol. 13, 377. 

BURRAGE (S.). The transmission of disease by flies and other in- 
sects. Proc. Indiana M. Soc, Indianap., 1900, p. 182. 

CALMETTB (E.). Del rol de los insectos en la propogacion de las 
enfermedades de los paises calidos. Rev. med. de Sevilla, 1899, Vol. 
23, p. 35. 

CAMPBELL (C). House flies and disease. Brit. M. J., Lond., 
1901, Vol. 2, p. 980, 

CARTAZ (A.). La transmission des maladies par les Insectes. 
Nature, Par., 1898-9, Vol. 27, p. 10. 

CHAPMAN (C.) and JOHNSTON (J.). House flies and disease. 
Brit. M. J., London, 1901, Vol. 2, p. 1267. 

CHASSAIGNAC (CHARLES). The Role of the Mosquito in the 
Propagation of Disease, Especially Malaria. (Annual Address, etc.). 
N. O. Med. & Surg. Jl,, 1905-06, vol. 58, p. 33. 

CIAURI (R.). Gli insettinella transmissione delle malattie infettive. 
Riforma med., Palermo, 1898, vol. 14, pt. 4, p. 565. 

CLEAVER (EMMA O.). The role of insects in transmission of dis- 
ease; a resume. Penn. M. J., Pittsburg, 19()0-1901, Vol. 4, p. 457. 

COPLIN (W. M. L.). The propagation of disease by means of in- 
sects, with special consideration of the common domestic types. 
Pennsylvania Med. JL, 1899-1900, Vol. 3, p. 241. Phila. M. J., 1899, 
Vol. 3, p. 1303. Reprint. 

CORREA (A.). Breve nocion de la perniciosa influencia que ejercen 
los insectos en determinadas enfermedades. Siglo med. Madrid, 1892, 
Vol. 39, pp. 386; 402. 

CRAIG (C. F.). The transmission of disease by certain insects; 
ticks, bedbugs, ants, etc. N. York M. J., 1898, Vol. 68, p. 593. 

CRAIG (T. C). The transmission of the cholera spirillum by the 
alimentary contents and intestinal dejecto of the common house-fly. 
Med. Rec, N. Y., 1894, Vol. 46, p. 38. 



INSECTS AS PROPAGATORS OF DISEASE. 55 

DAWSON (C. F.). The dissemination of infectious diseases by in- 
sects. Am. Vet. Rev., N. Y., 1901-2, Vol. 25, p. 266. 

DESFOSSES (P.). Du role de certains insectes dans la transmis- 
sion de quelques maladies. Presse med., Par., 1898, Vol. 2, annexes, 
182. 

' ELLIS (A. G.). Insects as a means of spreading infectious dis- 
eases. Medical Age. Detroit, 1899, Vol. 17, p. 641. 

FINLAY (C. J.). Mosquitoes considered as transmitters of yellow 
fever and malaria. Medical Record, N. Y., 1899, Vol. 55, p. 737. 

FLIES as agents in the New York cholera epidemic. Boston M. & 
S. J., 1893, Vol. 128, p. 170. 

FLY (The) as a propagator of typhoid fever. Medical Record, N. 
Y., 1898, Vol. 54, p. 486. 

FRANCIS (C. R.). Cholera caused by a fly (?). Brit. M. J., Lond., 
1893, Vol. 2, p. 65. 

FURNARI (S.). Insectes producteurs du cholera. J. d. conn. Med. 
prat. Par., 1836-7, Vol. 4, p. 25. 

GALIPPE (V.). Transport par un insecte de parasites infectieux. 
Compt. rend. Soc. de biol.. Par., 1889, 9. s., Vol. 1, p. 558.. 

GOODALL (T. B.). On entomology as a sanitary science. Tr. San. 
Inst., 1892, Lond., 1893, Vol. 13, p. 272. 

H. (J.). Les punaises et les moustiques comme agents de contagion. 
Riv. sclent, Par., 1897, 4. s.. Vol. 7, p. 110. Also, Translation: Med. 
Press & Circ, Lond., 1898, n.. s.. Vol. 65, p. 6. 

GRASSI (B.). La malaria propagee par le moyen de certain in- 
sectes particuliers. Arch. Ital, de Biologic, Turin, 1899, Vol. 31, p. 143. 

HEIM (F.). Du role de quelques coleopteres dans la dissemination de 
certains cas de charbon. Comptes Rendu de la Societe Biologique de 
Paris, 1894, Vol. 6, p. 58. 

HELBIG. Kerbthiere als Krankheitsverbreiter. Pharm. Central- 
halle, Dresd., 1901, n. F., Vol. 22, p. 729. 



56 HISTORY OF YELLOW FEVER. 

HELLER (C). Ueber septische Infection wahrscheinlich durch 
Insecten vermittelt. Mitth. a. d. Tubing. Poliklin., Stuttgart, 1886, 1. 
Hft, p. 1. 

HERICOURT (J.). El contagio por medio de los insectos. Habana 
med., 1900, Vol. 3, p. 33. 

HOMAN (G.). Insect agency in the spread of disease. St. Louis 
M. Gaz., 1898, Vol. 1, p. 133. 

HOMAN (G.). On the agency of parasitic vermin and other insect 
pests in the spread of disease. Am. Med., Phila., 1901, Vol. 2, p. 536. 

HOWARD (L. O.). Insects as carriers and spreaders of disease. 
Yearbook U. S. Dep. Agric. 1901, Wash., 1902, p. 177. 

HOWARD (L. O.). Experimental work with fungous diseases of 
grasshoppers. Ibid., p. 459. 

HUTCHINSON (J.). On flies, fleas, etc., as agents in the produc- 
tion of disease. Arch. Surg., Lond., 1895, Vol. 6, p. 386. 

JELLIFFE (S. E.). Insects as Carriers of Disease. Munsey's Maga- 
zine, N. Y., 1901, Vol 25, p. 707. 

JOLY (R. A. P.). Importance du role des insectes dans la trans- 
mission des maladies infectueuses. (Abstract.) Gazette des Hopi- 
taux, Paris, 1898, Vol. 71, p., 1202. 

KELLY (H. A.). A historical note upon Diptera as carriers of dis- 
eases; Pare; Declat. Johns Hopkins Hosp. Bull., Bait., 1901, Vol. 
12, p. 240. Also, reprint. 

LAVERAN (A.). Comment prend-on le paludisme? Revue d'Hy- 
giene, Paris 1896, Vol. 18, p. 1049. 

Ibid. Des mesures a prendre contre les moustiques. Revue G«n. 
de Clin, et de Therap., Paris, 1899, Vol. 13, p. 257. 

Ibid. Sur um anopheles provenant de Madagascar. Compte Rendu. 
Soc. de Biologic, Paris, 1900, II. Series, Vol. 2, p. 109. 

LEIDY (J.). The common fly as a factor in the transmission of 
disease germs. Phila. M. J., 1901, Vol. 7, p. 49. 

MACRAE (R.). Flies and cholera diffusion. Indian M. Gaz., Cal- 
cutta, 1894, Vol. 29, p, 407. 1 pi. Also, Reprint. 



INSECTS AS PROPAGATORS OF DISEASE. 57 

MADDOX (R. L.). Further experiments on feeding insects with the 
curved or "comma" bacillus. J. Roy.. Micr. Soc, Lond., 1885, 2d s.. 
Vol. 5, p. 941. 

MALARIA (A) conference in Rome. British Med. Jl., 1900, Vol. 1, 
p. 323. 

MALARIA (The) expedition to Sierra Leone. British Med. Jl., 
London, 1, 1899, Vol. 2, pp. 675; 746; 869; 1033. 

MALARIA (The) expedition to West Africa. Lancet, London, 1899, 
Vol. 2, p. 1041. 

MANSON (PATRICK). The Goulstonian Lectures on the life- 
history of the malaria germ outside the human body. British Med. JL, 
London, 1896, Vol. 1, pp. 641; 712; 774. 

Ibid. The mosquito and the malarial parasite. British Med. Jl., 
1898, Vol. 2, p. 849. 

Ibid. Surgeon-Major Donald Ross' recent investigations on the 
mosquito-malarial theory. British Med. Jl., 1898, Vol. 1, p. 1575. 

Ibid. The role of the mosquito in the evolution of the malarial 
parasite; the recent research of Surgeon-Major Ronald Ross. Lancet, 
London, 1898, Vol. 2, p. 488. 

Ibid. An exposition of the mosquito-malaria theory and its recent 
developments. Jl. Tropical Med., London, 1898-99, Vol. 1, p. 4.. 

MARCHOUX. Au sujet de la transmission du paludisme par les 
moustiques. Annals d'Hygiene et de Medecine Colonial, Paris, 1899, 
Vol. 2, p. 22. 

McCOLLOM (J. H.). The role of insects in the propagation of 
disease. Am. J. Nursing, Phila., 1901-2, Vol. 2, p. 181. 

McFARLAND (J.). Relation of insects to the spread of disease. 
Medicine, Detroit, 1902, Vol. 8, p. 1. 

MACKAIG (A.). Insects and cholera. Edinb. M. J., 1902, n. s., 
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MADDOX (R. L.). Experiments in feeding some insects with cul- 
tures of comma or cholera bacilli. Tr. Am. Micr. Soc. 1898, Lincoln, 
Neb., 1899, Vol. 20, p. 75. (1 Plate.) 



58 HISTORY OF YELLOW FEVER. 

MANNING (J.). A preliminary report on the transmission of 
pathogenic germs by the common house-fly. Am. J. Nursing, Phila., 
1901-2, Vol. 2, p. 920. Also: J. Am. M. Ass., Chicago, 1902, Vol. 38, 
1291. 

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Fliegen und stechende Insekten und uber den Zusammenhang von 
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von Stechfliegen, Mucken, etc., in den insektenreichen und insekten- 
armen Jahren. Apoth. Ztg., Berl., 1897, Vol. 12, p. 616. 

MARPMANN (G.). Ueber den Zusammenhang von pathogenen 
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1897, Vol. 22, p. 127. 

MONNIER (U.). Du role des insectes dans la propagation des 
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MUHLING (P.). Die Uebertragung von Krankheitserregern durch 
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NOTES on the part played by insects as carriers of infection. Brit. 
M. J., Lond., 1900, Vol. 1, p. 328. 

NUTTALL (G. H. F.). Zur Aufklarung der Rolle, welche stechende 
Insekten bei der Verbreitung von Infektionskrankheiten spielen. 
Cen tralbl. f. Bakteriol, etc. 1. Abt., Jena, 1898, Vol. 23, p. 625. 

NUTTALL (G. H. F.). Remarks upon a paper by Dr.. Calmette en- 
titled: "Intertropical medicine; on the part played by insects in the 
dissemination of the diseases of hot countries." J. Trop. M., Lond., 
1899-1900, Vol. 2, p. 182. 

NUTTALL (G. H. F.). Die Mosquito-Malaria Theorie. Centralbl. 
f. Bacteriol, 1. Abt., Jena 1899, vol. 25, pp. 161; 200; 245; 285; 387. 

NUTTALL (G. H. F.). On the role of insects * * * in the spread 
of bacterial and parasitical diseases. Johns Hopkins Hospital Re- 
ports, Baltimore, 1890, Vol. 8, p. 1. (3 plates.) 

Ibid. (Abstract.) British Med. Jl., London, 1899, Vol. 2, p. 642. 

Ibid. (Abstract.) Journal of Tropical Medicine, London, 1899-1900, 
Vol. 2, p. 107. 

Ibid. (Abstract.) Lancet, London, 1899, Vol. 2, p. 775. 

Ibid. (Translation.) Hyg. Rundschau, Berlin, 1899, Vol. 9, pp. 
209; 289; 393; 503; 606. 



INSECTS AS IROPAGATORS OF DISEASE. 59 

PAULLINUS (C. F.). Musca dysenteriae genitrix. Acad. nat. 
curios, ephem. 1687, Norimb., 1707, decuria 2, vi (ap.p.), 30-34. Also, 
trans. Abstr. Collect. Acad. d. mem., etc., Dijon, 1766, Vol. 7, 510. 

RAMIREZ (R.). The diptera from a hygienic point of view. Am. 
Pub. Health Ass. Rep., Columbus, 1898, Vol. 24, p. 257. Discussion, 
p. 356. 

RASAIL (F. v.). Sur les maladies qui peuvent etre I'oeuvre des 
insectes, et sur leur traitement. Experience, Par., 1838, Vol. 1, pp. 
425-429. Also: Ann. d med. beige, Brux., 1838, Vol. 2, 1-5. 

RENDER. Curious instances of pestiferous insects. Boston M. & 
S. J., 1832, Vol. 6, 53-56. 

ROSS (RONALD). Some observations on the crescent sphere- 
flagella metamorphosis of the malarial parasite within the mosquito. 
Transactions South Indian Branch British Med. Ass'n, Madras, 1895, 
Vol. 6, p. 334. 

Ibid. Indian Lancet, Calcutta, 1896, Vol. 7, p. 227. 

Ibid. Life-history of the parasites of malaria. Nature, London, 
1899, Vol. 60, p. 322. 

(Dr. Ross also published numerous articles on this subject, which 
will be found in the scientific journals from 1896 to 1900.) 

S. (A. H.). Typhoid fever and flies. Medical Record, N. Y., 1898, 
Vol. 44, p. 537. 

SALISBURY-SHARPE (W.). The influence of dust and flies in 
the contamination of food and the dissemination of disease. Lancet, 
Lond., 1900, Vol. 1, 1613. 

SANGREE (E, B.). Flies and typhoid fever. Medical Record, N. 
Y., 1899, Vol. 55, p. 88. 

SAUNDERS (J.). Is there a cholera fly, sui generis? Texas Health 
J., Dallas, 1889-90, Vol. 2, p. 397. 

SAVCHENKO (I.. G.). Materiali k etiologii choler'i; rol mukh v 
rasprostranenii choler'noi zarazi. (Data on the etiology of cholera; 
the role of flies in the diffusion of the contagion of cholera.) Vrach, 
St. Petersb., 1892, Vol. 13, p. 1131. Also, transl.: Centra Ibl. f. Bakteriol. 
u. Parasitenk,, Jena, 1892, Vol. 12, p.. 893. 



60 HISTORY OF YELLOW FEVER. 

SHEWAN (M.). Insects and infection. Indian M. Rec, Calcutta, 
1897, Vol. 12, p. 203. 

STILES (C. W.). Insects as disseminators of disease. Sanitarian, 
N. Y., 1901, Vol. 47, p. 3. Also: Virginia M. Semi-Month., Richmond, 
1901-2, Vol. 6, p. 53. 

SUTTON (R. S,). Typhoid Fever and Flies. Medical Record, N. 
Y., 1898, Vol. 44, p. 610. 

TRANSMISSION (La) des maladies infectieuses par les insectes, 
les arachnides et les myriapodes. Med. Mod., Par., 1899, Vol. 10, 
579. 

VEEDER (M. A.). The relative importance of flies and water sup- 
ply in spreading disease. Buffalo M. J., 1898-9, n, s.. Vol. 38, p. 663. 
Also: Med. Rec, N. Y., 1899, Vol. 55, p. 10. Also, Reprint. 

VEEDER (M. A.). Flies as spreaders of sickness in camps. Med. 
Rec, N. Y., 1898, Vol. 54, p. 429. Also, Reprint. 

VEEDER (M. A.). The spread of typhoid and dysenteric diseases 
by flies. American Public Health Ass'n Reports, Columbus, 1898, Vol. 
24, p. 260. (Discussion, p. 356.) 

VON HOLUB (C). Insekten als lebendes Substrat fur Kultivierung 
ansteckender Krankheiten des Menschen und der Tiere. Centralbl. 
f. Bakteriol. (etc) 1. Abt, Jena, 1901, Vol. 30, p. 284. 

WEBER (L. W.). Die Stubenflige als Uebertragerin ansteckender 
Krankheiten. Irrenpflege, Halle, a. S., 1898, Vol. 2, p. 191. 

WIESNER (A.). O prenaseni zarodku nakazlivych chorob lidskych 
i zvirecich cizopasniky koznimi, zejmena hmyzem. (The conveyance 
of the germs of contagious diseases of man and animals by insects.) 
Lek. rozhledy, Praha, 1899, Vol. 7, .p. 129. 

WILLIAMSON (G. A.). Contribution a I'etude du role pathogenique 
des insectes dans les pays chauds. (Transl.) Ann. Soc. de med. de 
Gand, 1901, Vol. 80, p. 248. 

WILLIAMSON (G. A.). The Cyprus sphalangi and its connection 
with anthrax (called locally sphalangi bite). J. Trop.. M., 1901, Vol. 
4, pp. 34; 44. 



PART SECOND 



YELLOW FEVER 



PRELIMINARY OBSERVATIONS. 



CHAPTER I. 

PERTINENT POINTS ABOUT YELLOW FEVER. 

Geographical Limits of Yellow Fever and Other Pestilential Dis- 
eases. — Mortality of Yellow Fever in September, Compared with 
Other Months. — Historic Mortalities from Yellow Fever. 

Geographical Limits of Yellow Fever. 



No disease possessing such pestiferous proclivities as 
yelloAv fever is confined within such restricted limits. In 
America, it has never prevailed further north than Quebec 
(latitude 46° 50') nor has it been noticed further south 
than Montevideo (latitude 34° 54\). In the Eastern 
Hemisphere, Swansea, in Wales (latitude 51° 37') has 
been its northernmost limit, while St. Paul de Loanda, in 
Africa (about 9° S.) has been the southernmost habitat. 
Its western limits have been the shores of the Pacific from 
Montevideo to Lower California, except on one occasion 
(1883) when an imported case died in San Francisco, 
Cal. In Europe, it has never been seen further East than 
Leghorn, in Italy (7° 56'). In Africa, Egypt and Mada- 
gascar are said to have been invaded by the disease, but 
the report lacks authenticity^ The same may be said of 
the alleged prevalence in Asia Minor during the cam- 
paigns of Napoleon. 

The present foci of yellow fever are still more restricted 
than formerly. Juan Guiteras recognizes the following 
three areas of infection : 

1. The Focal Tjone, in which the diseases is never ab- 
sent, including Havana, Vera Cruz, Kio Janeiro and 
other South American ports. 

2. The Perifocal Zone, or region of periodic epidemics, 
including the ports of the tropical Atlantic in America 
and Africa. 



64 HISTORY OF YELLOW FEVER. 

3. The Zone of Accidental Epidemics, between the 
parallels of 43° north and 35° south. 

To better understand the meaning of this eminent 
authority, the reader is referred to the map of the world, 
where he will observe three great regions of pestilential 
disease: First, of the plague; secondly, of cholera; 
thirdly, of yellow feyer. 

These regions are distributed as follows : 

From the equator to 20° North may be regarded as the 
true yellow feyer region. This includes the West Indies, 
the coast towns of Mexico, the Isthmus of Panama, Col- 
umbia, Venezuela, the eastern shores of South America 
as far south as the Kio de la Plata, and the western coast 
of Africa, embracing Sierra Leone and the Gold Coast. 

From 30° to 40° North, in the Eastern Hemisphere, is 
the region of the plague, including Arabia, Egypt, Turkey 
and Asia Minor. 

From 20° to 40° North, in the Eastern Hemisphere, is 
theValley of the Ganges, the principal centre of the cholera 



Mortality of Yellov^^ Fever in September. 

A study of the statistics of yellow fever demonstrates 
the peculiar fact that the disease is connected in its epi- 
demic appearance with certain seasons of the year. The 
months of July, August and September are those in which 
epidemics are more prevalent and the disease seems to at- 
tain its greatest mortality in the latter month. A resume 
of nine epidemics in New Orleans, made by Chaille, and 
completed (so far as 1905 is concerned) by the compiler 
of this work, shows that in six of these visitations, the 
mortality was greatest in September, viz : 



^ Some Yellow Fever Data, by S. E. Chaille, New Orleans 
Medical and Surgical Journal, 1905, vol. 58, p. 191. 



PERTINENT POINTS ABOUT YELLOW FEVER. 



65 



Mortality in Xine Notable Epidemics in New 
Orleans. 



1 


5 


1848 
1853 
1854 


'O 


QO 


1 


QO 

00 




May 

June 

July 

August 

SEPTEMBER. 

October ; 

November 

December 

fflontnsDjRDOWQ..- 


74 
965 

1000 

198 
12 
10 
445 


33 

200 

467 

126 
20 

22 


31 
1521 
5133 

982 

147 

28 

4 


2 

29 

53-2 

1234 

490 
131 

7 


5 

382 
1286 

874 

97 
19 

7 


2 

132 

1140 

2204 

1137 

224 
15 


3 

255 

1637 

1072 

103 

26 


26 
1025 

1780 

1065 

147 

3 


42 
217 
III 

61 
6 




total 


1 • 
2804 872 7848 


2425 j 2670 


4854 1 3107 


4046 





A glance at the above figures proves that in only three 
instances (1853, 1858 and 1905) August proved more 
fatal than September. In 1853, the mortality reached the 
appalling aggregate of 5133 in August, against 892 in 
September and a grand total of 7848 for the entire year. 

A search into the records of nearly every place where 
yellow fever has been epidemic reveals the same state of 
affairs, with the exception of Havana, where July seems 
to be the most fatal month. 

Even as far back as 1793, Currie,^ in speaking of the 
gTeat epidemic at Philadelphia that year, says : 

''In September, the disease increased amazingly. In 
the course of the month, about 1400 citizens were added 
to the list of mortality; towards its close, from 50 to 90 
were buried of a day, though the mercury uoav seldom rose 
above 80°." 

''After the first of September, there was no disease to 
be seen but yellow fever."^ 

-a Treatise on the Synochus Icterodes, etc., by William 

Cuirie (1794), p. 15. 
•'Epidemic at Philadelphia of 1797, Rush, vol. 5, p. 19. 



66 HISTORY OF YELLOW FEVER. 

In 1822, when New York was visited by the disease, the 
deaths in September monnted up to 110, against 58 in 
August and 90 in October.^ 

The excess in mortality in September over the other 
months during the prevalence of yellow fever, has also 
been noted in the following epidemics: 

New York, 1799 ; Providence, K. I., 1797; Baltimore, 
1819; Wilmington, (Del.) 1798; Charleston, (S. C.) 1807, 
1817, 1819, 1824, 1827 and 1838; Natchez, 1823 and 1825; 
Mobile, 1839; New Haven, (Conn.), 1794; Ncav Orleans, 
1819, 1820, 1824 and 1833. 

La Koche^ notes that the mortality has occasionally 
been greatest in August, as was the case in Charleston in 
1838 and in New Orleans in 1817, 1839 and 1853. But 
these were isolated exceptions. 

The apparent reason for the greater mortality in Sep- 
tember seems to be that the disease, beginning early in 
summer, has had time to spread and to attack a larger 
number of persons; also, the virulence is greater because 
by that period the infected mosquitoes are more numerous 
and, everything else equal, exposed persons receive more 
bites and consequently a larger dose of poison.^ 

This did not follow in 1905, because by September the 
effect of the active anti-mosquito campaign was showing 
itself by diminishing number of cases as well as by lower 
mortality. 

Historic Mortalities From Yellov^ Fever. 

Whenever yellow fever has spread its sombre mantle 
over a community, it has left in its wake countless heca- 
tombs. 

^'The reader need scarcely be informed," saj^s LaBoche, 
in his monumental work on yellow fever, "that the yellow 
fever, wherever it has assumed the epidemic form, has 
fully established its claims to being classed among the 

* Proceedings Board of Health of the City of New York (1823), 

p. 123. 
'^Vol. 1, p. 545. 
" See Article by Dr. Chassaignac, in the medical part of this 

volume. 



PERTINENT POINTS ABOUT YELLOW FEVER. " 6? 

most formidable diseases to wliicli the human body is 
liable." 

The island of St. Lucia, in the West Indies, furnishes 
the earliest authentic example of great mortality from yel- 
low fever. In 1664, according to Keating,' it killed 1,411 
out of a population of 1,500 soldiers, being in the ratio 
of 1.06 of the whole number. In 1665, in the same locali^ 
ty, out of 500 sailors, 200 died, being one in 2:5; and 
again, in 1666, the unfortunate island was invaded by the 
disease, when every man, woman and child, 5,000 in all, 
died. 

In 1793^ in Grenada, West Indies, yellow fever appeared 
among the sailors, the proportion of deaths in cases 
amounting to 1 in 3 ; and of a total of 1,130 soldiers, 630 
died. 

In 1794, the disease attacked Sir Charles Gray's Army, 
in the Windward and Leeward Islands, and of an esti- 
mated population of 12,000, there was a mortality of 
6,012. 

In Guadeloupe, in 1796, out of an estimated population 
of 20,000, there was a mortality of 13,807. That same 
year, out or 367 artillerymen stationed at the island, 129 
died. In 1802, Guadeloupe was again decimated, 5,057 
deaths occurring in a iDopulation of 16,363. 

In 1802, at San Domingo, in a population estimated at 
40,000 (principally soldiers), there were 27,000 cases and 
20,000 deaths. The mortality among French troops in the 
West Indies in 1802 amounted to 57 per cent. 

Quebec, Canada, was invaded by yellow fever for the 
first and last time in 1805. Of one company of 55, be- 
longing to an English regiment, all but six died. 

The greatest mortality ever recorded in Havana was 
in 1819, when 5,162 died. As yellow fever had visited 
Havana almost every year since 1620, this mortality is 
especially worthy of note. 

In 1852, at Barbadoes, West Indies, out of 1,380 sol- 
diers, there were 879 cases and 173 deaths. 

At Martinique, during a period of five years, 1802 to 

^Keating: History of the Yellow Fever of 1878, p. 77. 



68 HISTORY OF YELLOW FEVER. 

1807, in a population of 11,085 soldiers, there were 8,673 
cases and 2,891 deaths. 

According to Joseph Jones,^ 'the total deaths from all 
diseases in New Orleans from 1838 to 1883, a period of 
forty-five years, amounted to 272,619, of which 31,207 
were from yellow fever, 10,009 from cholera and 6,436 
from smallpox. It will thus be seen that of the 47,642 
deaths from contagious and infectious disease, the mor- 
tality from yellow fever reached the appalling figure of 
31,207, or a 3^early average of 693 for the period above 
mentioned. 

The greatest mortality from yellow fever in a single 
year in New Orleans took place in 1853, when 7,848 died. 
From 1853 to 1858, a period of six years, the mortality 
Avas as follows : 

1853 7,848 

1854 2,425 

1855 2,670 

1856 74 

1857 200 

1858 4,845 

Total for six years '....... 18,062 

Since 1858, there have been only two great epidemics 
in New Orleans: 1867, when 3,107 died, and- 1878, when 
the pestilence made 4,046 victims. 

The North also presents a melancholy record. 

In his sumnmry of the epidemics which devastated 
Philadelphia in the past. La Roche states that during the 
visitation of 1699, Avhen the city was only 17 years old 
and the population did not exceed 3,800, the mortality 
from yellow fever Avas 220, or one in 17.3 of the entire 
number of residents. Ninety- four years later (1793), 
when the population of Philadelphia'^ amounted to 60,000, 
occurred the '^gTcat epidemic," commencing in August 
and ending in December, and causing a fearful total of 
4,041 deaths. Four years later (1797), a severe epidemic 

"Jones: "Medical and Surgical Memoirs, vol. 3, part 2, Table 



PERTINENT POINTS ABOUT YELLOW FEVER. 69 

visited the city, the mortality amounting to 1,300. The 
year following (1798), j^ellow fever again assumed a 
virulence which caused such a widespread terror, that 
nearly the whole population fled. The epidemic of that 
3'ear made 3,645 victims. It will thus be seen that in the 
short space of five years (1793 to 1798), yelloAv fever 
made the melancholy record of 8,986 victims in that 
scourge-ridden city. 

In New York, Boston, Baltimore, Portsmouth (Va. ) 
and on the North Atlantic seaboard, the disease has at 
times assumed pestilential proportions, the details of 
which will be found in that part of this volume devoted 
to the history of yellow fever. 

Europe furnishes an appalling list of mortalities. Ac- 
cording to LaRoche, Spain has been the principal sufferer 
on occasions of this kind, experiencing, in the course of 
nine epidemics— 1800, 1801, 1803, 1804, 1810, 1813, 1818, 
1819 and 1821 — the immense loss, by yellow fever, of up- 
wards of 130,000 individuals. During one single season — 
that of 1800 — not less than thirty places in Andalusia 
were visited, and in them the loss amounted to 61,363. 

The year 1804, according to LaRoche, was another of 
great calamity. On that occasion, twenty-five places in 
Spain, with a combined population of 427,228, lost 52,559 
souls, or one in 8.12. 

The disease also prevailed epidemically in some parts 
of France, England, Italy and Portugal during the 
eighteenth and nineteenth centuries, but Spain seems to 
have been the most fertile spot for the propagation of 
yellow fever in the Old World. 



70 HISTORY OF ^"ELLOW FETER. 

CHAPTEK II. 

NOMENXLAl URE OF YELLOW FEATR. 

Peculiar Names given the Disease by Medical Writers. — A List con- 
taining One liundred and Fifty-two Synonyms. 

Xames IX Vogue at the Present Day. 

English: Yellow Fever. 
French : Fievre Jaime. 
Spanish : Fiebre Amarilla. 
Portugese: Febre Amarella. 

Oerman : Gelbes Fieber. 
Italian : Febbre Gialla. 
Latin : Febris Flava. 

Synonyms. 

Xo disease under heaven has had more synonyms than 
yellow fever. Beginning witli 14:91, when it was generally 
designated by the name of Contagion, and ending with 
the Year of Grace 1907, when the term Mosquito Fever 
seemed decidedly appropriate, the nomenclature of the dis- 
ease has been stuxjendoiis. The subjoined list, which has 
been carefully prepai'ed from the wi^itings of American, 
English, Spanish, Italian, Portugese and Spanish chron- 
iclers, will convey an idea of the peculiar names which 
were used in former times to designates the yellow 
scourge, the nature and origin of which we are no wiser 
to-day than were those worthy and illustrious observers. 

1. American Bilious Malignant Fever. 
Moultrie, 1719. 

2. American Fever. 
Ceresa, 1S29. 

3. American Pestilence. 

Haygai;th, in a work published in 1801, theorizes 
on the "prevention of infectious fever, especially 
the American Pestilence." 



'synonyms of yellow fever. 71 

4. American Typhus. 

Term used by the disciples of the school of Bally. 

5. American Yellow Fever. 

Lining, in his ''Essays and Observations;" also 
Jolivet, 1831, and others. 

6. Ardent Fever. 

Fermin thus mentions it in his work on "Traite 
des Maladies les Plus Frequentes a Surinam,'^ 
published in 1763. 

7. Ardent Summer Fever. 

English writers, middle of Eighteenth Century. 

8. Ataxic Typhus. 
Bally and his followers. 

9. Autumnal Endemial Epidemic Fever. 
Davidge, in a work published at Baltimore, in 1798. 

10. Autumnal Epidemic Fever. 
Shaw, 1804. 

11. Autumnal Fever. 

Yaughan, in his ''Concise History," etc., 1802. 

12. Barbadoes Distemper. 

American and English writers, in the beginning of 
the Eighteenth Century. 

13. Barbadoes Fever. 

Philadelphia, in 1699, because the pestilence of that 
year was imported from Barbadoes, West Indies. 

14. Barcelona Fever. 

Kochoux, 1822, and those who advocated the theory 
that the epidemics Avhich ravaged Spain in the 
beginning of the last century, were endemic to 
that country. 



72 HISTORY OF YELLOW FEVER. 

15. Bilious Fever. 

Gamble, Kocliefort, Hughes, Chanvalon, Bajon and 
Fermin. 

16. Bilious Epidemic Fever. 
Yates, 1813. 

17. Bilious Fever of Warm Climates. 

English and American writers in the middle of tlie 
last century. 

18. Bilious Malignant Fever. 
Joseph Brown, 1797. 

19. Bilious Putrid Fever. 
Hillary. 

20. Bilious Kemittent Fever. 
Arnold. 

21. Bilious Kemittent Putrid Fever. 
Rush and his disciples. 

22. Bilious Remittent Yellow Fever. 
Rush and his school. 

23. Bilious Remitting Fever. 
Rush, 1793. 

24. Bilious Yellow Fever. 
Williams. 

25. Black Vomit. 

Popular name adopted by old English writers and 
derived from the Spanish Vomito Negro. 

26. Bronze John. 

Chambers' Encyclopedia, article on ^^Y^ellow Fever." 

27. Bulam Fever. 

Pym, Chisolm, and their disciples, who propagated 
the visionary doctrine that the fever had been 
imported from the Island of Bulam, West Africa. 



SYNONYMS OF YELLOW FEVER. , 3 

28. Calentura. 

This name had its origin in the dogma that heat 
was the prime cause of yellow fever. It was only 
in the beginning of the nineteenth century that 
this designation was abandoned by the Spaniards, 
who substituted '^Fiebre Amarilla," a term which 
is used to this day in Spain and in Central and 
South America. 

29. Calentura Amarilla. 
Cibat, 1803. 

30. Calentura Maligna Contagiosa. 

Gonzales, in his dissertation on the yellow fever in 
Cadiz, published in 1801. 

31. Calentura Amarilla De America. 
Jose Fernandez de Madrid, 1821. 

32. Calenturas Putridos y Maligna. 
Masterall, 1797. 

33. Calenturas Tifoideas. 
Burdin, 1820. 

34. Calenturas Thermo-Adynamica y Therjmo- 

Ataxia. 
Jose Fernando de Madrid, 1821. 

35. Cardite Amarille. 
Mentioned by Berenger-Feraud. 

36. Causos or Ardent Fever. 
Desperriere, Gillespie. 

37. Causus. 

Name used by Fermin, in his work above quoted, 
and by Miller, McArthur and others. 

38. Cxvusus Malin D'Amerique. 
Berenger-Feraud is authority for this expression. 



74 HISTORY OF YELLOW FEVER. 

39. Causus Tropicus Endemicus. 

Moseley, in his '^Treatise on Tropical Diseases/' 
etc., 1795. 

40. Chapetonada. 

Coreal and Ulloa. This name, which signihes 
'^brigand" in the Peruvian language, was origin- 
ally given to the followers of Pizarro by the na- 
tives and was subsequently adopted by the in- 
habitants of Martinique to mean all Europeans 
who landed on their shores. These unfortunate 
colonists dying by the thousands from the 
endemic fever of the country, the name was 
finally apiilied to the disease itself. 

41. COCOLITZLE. 

Herrera, in his famous work published in 1601, 
says that this name was given by the Carib In- 
dians to the disease. 

42. Concentrated Endemic Fever. 

Jackson, in a work published in Edinburg, 1789. 

43. Contagion. 

This name is quite prevalent in the writings of early 
Spanish and French authors from 1494 to 1634. 
After that date and up to the end of the Seven- 
teenth Century, the diseas was designated as 
Coup de Bar re by the French and Cedent lira by 
the Spanish. 

44. Continua Putrida Icterodes Caroliniensis. 
Macbride. 

45. Contagious Fever. 

Rochedort, Bajon, Fermin, Chanvalon, Hughes, 
Schotte. 



SYNONYMS OF YELLOW FEVER. 75 

46. Coup De Barre. 

Labat and other early Antillian chroniclers. The 
literal meaning of the word is: "I am struck 
with a whip-stock," and is expressive of the 
suddenness of the onset of the malady and the 
muscular pains Avhich accompany it. 

47. Elodbs Icterodes. 
Vogel. 

48. Endemial Causus, or Burning Fever. 
Mentioned by Moseley in his treatise on Tropical 

Diseases. 

49. Epauctus Malignus Flavus. 
Goode. 

50. Epidemic. 

Sahagun, Salgado, Salamanca and other early 
writers. 

51. Epidemical Distemper. 
Sandiford. 

52. EXAMTHEMA EXTERNUM CONTAGIOSA. 

According to Jackson (1821), this name was ap- 
IDlied to the disease by Spanish physicians during 
the great epidemics in Andalusia in the begin- 
ning of the last century. 

53. Febbre Gialla Pestilenziale D'Amerique. 
Palloni and other Italian writers, in the beginning 

of the nineteenth century. 

54. Febbre Livorno. 

Palloni and Tomasini, in their descriptions of the 
epidemic at Leighorn in 1804. 

55. Febre Endemica Indiarum Occidentalum. 
Latin writers. 



6 HISTORY OF TEIXOW FE\:ER. 

56. Febee Flata Indiae Occidextales. 
Cnllen, 177'^. 

57. Febre Flava Regiorum Calidaefm. 

Fisher. 1705. 

58. Febre Hlspanae Flava. 
Fago, ISIS. 

59. Febre Ixdiae Occtdextams. 

MackitTTick. 1766. 

60. Febris Arlens Aestiva. 
Roiippe. 177:^. 

61. Febris Arbens BiuasA. 
Towne, 1726. 

62. Febris Cum Xigeo To]iiito. 
Same adopted by DoweU. 

63. Febels Flavae Ameeicaxae Causis. 
Ferrello, 1825. 

61. Febels Icterodes. 

General term adapted br medical men from 1701 to 
1815. 

65. Febris Maugxa Biliosa, 

Moultrie. 

66. Febris Putrid a C<::LLOQrATivA. 
Ronppe, 1772. 

67. Febels Typhus Icterodes. 
Dowell. 

68. FiEBRE Amarilla Hispaxorum Et Hispaxo- 
Americaxum. 

Early Spanish writers. 



SYNONYMS OF YELLOW FEVER. 77 

69. FiEVRE Des Lacs. 
Berenger-Feraud. 

ro. FiEYRE Gastro-Adynamique. 
Pinel. 

71. FlEYRE JaUXE. 

Modern French writers. 

72. FlEVRE Jaune D'Amerique. 
Valentin. 

73. FlEVRE Matelotte. 

Earlj' French writers. This exjDression owed its 
origin to the belief that seamen were especially 
susceptible to yellow fever. 

74. FlEYRE PUTRIDE CONTINUE. 

Pugnet. 

75. FlEYRE Spasmodico-Lypirienne Des Pays Chauda. 
Chabert, 1821. 

76. Flaya Febre Tropica. 
Bartholomaei, 1822. 

77. Flaya Indiarum Febre. 
Hunter, 1798. 

78. Gastro-Cephalite. 
Vatable, 1828. 

79. Gastro-Enteritis. 
LeRiYcraud. . 

80. Gelbe Fieber. 

Longermann, 1804, and German writers to the 
present day. 

81. Gibraltar Feyer. 

Term used by medical writers in the beginning of 
the Nineteenth Century. 



78 HISTORY OF YELLOW FEVER. 

82. Haemagastkic Pestilence. 

Copland, "DictionarT of Practical Medicine." 

83. Haemelitic Epidemic. 
Nicholson. 

84. Inflammatory Endemic. 
Dickson, 1819. 

85. Jail Feyer. 

So called by the inhabitants of the island of Ber- 
muda, West Indies, in 1779, because the fever 
first manifested itself among the jjrisoners of 
war. 

86. Kendal's Fever. 
Humboldt and Hughes. 

87. Maladie De La Saison. 

Earlv Antillian writers, who propagated the theory 
that the disease only occurred at certain seasons 
of the year. 

88. Maladie Dr Diable. 

Falligant. The word which means '*The Devil's 
Illness," was inspired by the terror it created. 

89. Maladie Du Pays. 

Early Antillian Chroniclers. This signifies, liter- 
ally, ^'endemic disease," and is, in our opinion, 
decidedly apj^ropriate. 

90. Maladie Matelotte. 

Early French writers. Companion expression of 
''Fievre Matelotte." 

91. Maladie Speciale Du Foie. 
Berenger-Feraud. 



SYNONYMS OF YELLOW FEVER. 79 

92. Mal De Siam. 

So called because of the general belief in early col- 
onial days that the disease had been imported 
from Siam. It is mentioned by Labat, Chavalon, 
Desportes, Moreau de Saint-Mery, and other 
chroniclers of the period and Avas known by this 
name in Martinique and San Domingo near the 
close of the seventeenth century. It is found 
designated by this name in the old Government 
and local records of these islands. 

93. Maladie Spasmodico-Lyperienne Des Pays 

Chauds. 
Chabert. 

94. Malignant Fever. 
Walsh. 

95. Malignant Ataxic Fever. 
Disciples of the School of Bally. 

96. Malignant Contagious Fever. 
Cathrall. 

97. Malignant Fever. 

Warren, 1740; Blanchini, 1750. 

98. Malignant and Nervous Fever. 
Berenger-Feraud. 

99. Malignant Pestilential Fever. 
Chisolm, 1795. 

100. Malignant Putrid Pestilential Fever. 
Berenger-Feraud. 

101. Malignant Kemittent Fever. 
McDiarmid, London Med. Gaz., vol. 2, p. 444. 

102. Malignant Yellow Fever. 
Berenger-Feraud. 



80 HISTORY OF YELLOW FEVER. 

103. Matlazahuatl. 

Humboldt says that the Aztecs thus called the dis- 
ease and claims that their records speak of the 
j)estileuce as ravaging Mexico eren as far back 
as the Eleventh Century. 

104. Meditteeaxeax Fever. 
. Burnett, 1816. 

105. Mexixgo-Cephalo-Gast;rite. 
Maher. 

lOG. Mosquito Fever. 

This expression was first used by Xew Orleans 
newspapers in 1905, to commemorate the most 
glorious victory over pestilential diseases which 
has ever been achieved. 

107. ZS^AUTiGAL Typhus. 

Adouard, Faget, Gamgee, and adherents of the 
ship origin of yellow fever. 

108. Novae Pestis Americae. 
Eisner, 1805. 

109. ]S^ERvous Gastric Fever. 
Berenger-Feraud. 

110. New Distemper of 1791. 

American writers, beginning of Nineteenth Cen- 
tury. 

111. Occidental Pestilence. 
Berenger-Feraud. 

112. Oghropyra. 

From ''Ochre," yellow, and "Pyra,-' fire, meaning, 
literall}', a burning or ardent fever. 



SYNONYMS OF YELLOW FEVER. 81 

113. Palatine Fever. 

Name originally given to the pestilence which 
reigned at Philadelphia in 1741, owing to the 
popular notion that it had been brought to the 
City by some German euiigrants from the Pala- 
tinate. 

114. Peste or Pestilencia. 
Early Spanish chroniclers. 

115. Peste Caraibe. 

Early French and Spanish waiters. 

116. Pestilential Fever. 

Eochefort, Bajon, Hughes, Fermin, Chanvalon, 
Chirac. 

117. Pestis Tropicus. 
Hosack. 

118. POULICANTINA. 

Carib Indians. 

119. Putrid Inflammatory Synocope. 
Berenger-Feraud. 

120. Putrid Fever. ; 
Hughes, 1750. 

121. Putrid Malignant Fever. 
Berenger-Feraud. 

122. Putrid Synocope. ' 
Berenger-Feraud. 

123. Ship Fever. 
Audouard and his school. 

124. Spanish Fever. 

Cadet, 1822. _ , 



82 HISTORY OF YELLOW FEVER. 

125. Strangers* Fever. 

Simons, 1S39. So called in Charleston. S. C, as 
the disease was thought to attack only new- 
comers, 

126. Synochus, 
Young. 

127. SYxocHrs Atrabiliosji. 
Schotte, 17S2. 

128. Syxochus Icterodes. 

Currie, 1794. 

129. Syxochus Maligna. 
Cathrall, 1791. 

130. Tanardilla. 

Moreau de Saint-Mery says this designation was 
quite prevalent in San Domingo and Spanish 
America. It is derived from the Sj)anish and 
means a febrile illness followed by jaundice. 

131. TiFUs Icterodes, 
Flores, 1813. 

132. Tritopheia Americana, 
Sauvages. 

133. Tropical Fever. 
Berenger-Feraud. 

131. Tropical Continued Fever. 
Lemprierre. 

135. Tropical Endemic Fever. 
Dickson: Belcher. 

130. Typho-Icterode Animadversiones. 
Leiblin, 1815. 



SYNONYMS OF YELLOW FEVER. 83 

137. Typhus. 

According to Laroche, yellow fever has been re- 
garded as a hybrid form of typhus by such emi- 
nent authorities as Blane, Lempriere, Dickson 
and Chisolm. 

138. Typhus Acgidentel Ou Icterique. 
Savaresy. 

139. Typhus Amarilla. 

This term came into general use shortly after the 
War of 1812. It was then that the great discus- 
sion about the contagiousness of yellow fever 
reached its zenith. 

140. Typhus Icterodes Padecido. 
Moreno, 1813. 

141. Typhus Cum Flavedine Cutis. 
Cullen. 

142. Typhus D'Amerique. 
Bally. 

143. Typhus Icterodes. 
Sauvages. 



144. Typhus Tropicus. 

Qgiish a 

century. 



English and American writers, beginning of last 



145. Typhus Miasmatique Ataxique Putride Jaune. 
Bally. 

146. VOMITO. 

From 1709 to 1790, Yellow Fever was popularly 
known as ''Vomito." 

147. VoMiTO Amarilla. 

According to Chambers' Encyclopedia, article on 
Yelloiv Fever, the disease is designated by the 
above name in Central America. 



84 HISTORY OF YELLOW FEVER 

148. VoMiTO Negro Epidemico. 
Gastiblondo, 1755. 

149. VoMiTO Xegro. 

Early colonial writers. The word is Spanish and 
means ''Black Yomit.'' 

150. YOMITO Prieto. 

Spanish writers. Same meaning as ''Vomito Xe- 
gro." 

151. Yellow Fever. 

At the present day the name Tellow Fever and 
translations is used by all writers, to the exclu- 
sion of all other names. The term was first used 
by Griffith Hughes in 1750, in Ms ^'Xatura: His- 
tory of Barbadoes." 

152. Yellow Jack. 

A popular name for the disease in England and the 
United States. 



CHAPTER III. 

HISTORICAL SUMMARY. 

Where was the Cradle of Yellow Fever? — The Theory of American 
Origin. — The African Theory. — The Asiatic Theory. — The Gulf Stream 
Theory. — Observations by the Author on the above Theories. 

Where was the Cradle of Yellow Fever? 

There is no subject in medicine upon which there has 
been such a diversity of opinion as the origin of yellow 
fever. From the time of Bally, in the seventeenth century, 
when the controversy can really be said to have begun, to 
the present day, medical writers and historians have been 
theorizing and conjecturing on the matter, but nothing 
has been adduced which can, in the remotest way, be said 
to have thrown any new light on the vexed and seemingly 
unending question. As soon as one w^riter would launch 
a doctrine which, in his opinion, was plausible and in- 
contestable, another would come to the front and adroitly 
dissect it,' laying bare its imperfections to the glaring 
light of logic, and inaugurate a theory of his own, which, 
in turn, would be mercilessly denuded of every semblance 
of common sense by a third disputant, who would bring 
columns of statistics and page after page of denuci- 
atory arguments to prove that no one but himself was 
on the right track and that every previous writer hold- 
ing a contrary view had either erred owing to gross ignor- 
ance of what he was proclaiming or had intentionally 
juggled with the facts. 

Some authors assert that yellow fever has affected man- 
kind from pre-Christian times, citing in support of their 
contention the waitings of ancient observers and philoso- 
phers ; others claim that it is a purely American product 
and deny its existence before the discovery of America, 
laying the blame for its importation into Europe and 
Africa to the slave trade and indiscriminate commerce of 
colonial days. 

A careful search into the voluminous literature on the 
origin of yellow fever naturally leads to the query: 

Where was the cradle of yellow fever? 



86 HISTORY OF YELLOW FIVER. 

The problem is as difficult of solution as the SyUogismus 
Crocodilus of Aristotle. After centuries of discussion, we 
are no nearer the truth than our forefathers were. Such 
eminent observers as Bancroft. Cornilliac, Bally, Moreau 
de Jonnes, Physick, Chaille, Toner, ^aint-Merv, Finlav, 
Cullen, Sternberg, Ferreira, Kochefort, Audotiard, Ber- 
anger-Feraud, Valdez, Bush, La Koche, Jones, Faget and 
others, have conjectured ah libitum upon the origin of the 
disease, but their conclusions have only left us a diver- 
gence of opinion which no amount of conjecture can 
bridge and which defies the most abstruse laws of com- 
mon sense and logic. 

That great American philosopher. Humbolt,^ admir- 
ably sums up the situation in the following words : 

"In all climates men appear to find some consolation 
in the idea that a disease considered pestilential is of for- 
eign origin. As malignant fevers easily originate in a 
numerous crew cooped up in dirty vessels, the beginning 
of an epidemic may be frequently traced to the period of 
the arrival of a squadron; and then, instead of atribut- 
ing the disease to the vitiated air contained in vessels de- 
prived of ventilation, or to the elfects of an ardent and 
unhealthy climate on sailors newly landed, they affirm 
that it was imported from a neighboring port, where a 
squadron or convoy touched at during its navigation from 
Europe to America. Thus we frequently hear in Mexico 
that the ship-of-war which brotight such-or-such a viceroy 
to Vera Cruz has introduced the yellow fever which for 
several years had not prevailed here; and in this manner 
during the season of greatest heat the Havana, Vera Cruz, 
and the ports of the United States mutually accuse one 
another of communicating the germ of the contagion. It 
is with the yellow fever as with the mortal typhus known 
by the name of 'Oriental pest,' which the inhabitants of 
Egypt attribute to the arrival of Greek vessels, while in 
Greece and Constantinople the same pest is considered 
as coming from Eosetta or Alexandi-ia." 

Let us noAv consider these theories seriatim. 



' Humboidt: Poltical Essay on the Kingdom of New Spain, vol. 
I, ]). 219. 



HISTORICAL SUMMARY. 87 

1. The Origin of Yellow Fever. 

A search through musty archives, time-yellowed tomes 
and worm-eaten volumes two or more centuries old, re- 
veals the fact that the first epidemic of yellow fever in the 
New World, took place in the West Indies in 1647, the de- 
tails of which are faithfully chronicled in Ligon's History 
of Barbadoes. Outbreaks of the fever are noted by other 
observers as having caused much mortality before this, 
among which is the pestilence which mowed doAvn the fol- 
lowers of Columbus in 1494 and the series of epidemics 
in Brazil which lasted from 1688 to 1694.- 

We shall now proceed to give the views of the best 
authorities upon the subject, believing with Quintilian that 
^'searching into every particular, we sometimes discover 
truth where we least expected to find it.-' 

The earliest authentic description of yellow fever is 
that of the Portuguese pln^sician Ferreira da Rosa, who 
observed the epidemics which prevailed at Olinda, in 
Brazil, from 1687 to 1694, shortly after the Portuguese 
army had made the conquest of Pernambuco. Humboldt 
notes the fact that it is known with certainty that in 
1691 yellow fever manifested itself at the Island of Bar- 
badoes, West Indies, where it went by the name of ''Ken- 
dal's Fever," without the slightest proof that it was 
brought there by vessels from Pernambuco. The natural 
conclusion is that the disease must have been epidemic in 
the locality at that time. 

Ulloa,^ siDcaking of the Chapetonadas, or fevers to 
which Europeans were exposed on their arrival in the 
West Indies, relates that according to the opinion of the 
people of the country, the vomit o prieto was unknown at 
Santa Martha before 1729 and at Carthagena previous to 
1740. The first epidemic at Santa Martha is described by 
de Gastilbondi,"^ a Spanish physician. Since that time, 
the inroads of yellow fever have been almost universal 

-Ferreyra da Rosa: Traitado da Constitucion Pestilencial de 

Peniambuco, by Joam Ferreira da Rosa (1694), 
"Ulloa; Voyage, etc., pp. 41 and 149. 
*Gastiblondi: Lazuriaga de la Calentura Biliosa, p. 7. 



88 HISTORY OF YILLOW FEVER. 

and are given in detail under proper classifications in 
other portions of this yolume. 

The Twentieth Century Practice, a work which occu- 
pies a foremost place in medical literature, in an article 
on the history of yellow fever, says \^ 

''It would afford the student of the disease a great deal 
of satisfaction if he could locate its first habitat, but that 
privilege is denied him. As far as we moderns are con- 
cerned, ,we date the disease from the time of Columbus 
and his followers. The disease, no doubt, existed in pre- 
historic times, and is buried in that nebulous past that 
envelopes so many infectious and contagious diseases." 

La Eoche^ adheres to the belief that the West Indies, 
and part of the coast of North and South America, con- 
stitute the proper soil of yellow fever. 

Herrera, Oviedo and other early Spanish writers, relate 
that shortly after the arrival of the Europeans in Ameri- 
ca, they were decimated by a sudden and very fatal pestil- 
ence, which committed fearful ravages. Columbus him- 
self was stricken by the malady on his second voyage 
while at the island of Mona, West Indies, and ts as in 
great danger, escaping death by immediately sailing for 
the high seas. 

Berenger-Feraud,^ one of the ablest and most conscien- 
tious authorities on the subject, tells us that the first at- 
tempts to colonize Porto Eico were frustrated by the pre- 
valence of this unknown pestilence and notes"^ the fact 
that of the 1500 men which had been left by Columbus at 
Monte Cristo in 1493, there remained, two years after- 
wards, only two hundred foot soldiers and twenty cavalry- 
men. The attempts to colonize St. Domingo (1191 and 
1501), Porto Eico (1508 and 1513), the Isthmus of 
Darien (1509 and 1511), were also retarded by the rav- 
ages of the same disease. So fatal was this malady, es- 
pecially in Saint Domingo, that the Spanish Government, 
loth to lose this coveted possession, but not wishing to ex- 
pose its soldiers to annihilation, sent as colonists to the 



"Page 401. 

"La Roche: Vol. 1, p. 219. 

'Gazette des Hapitaux, 1884, vol. 57, p. 660. 



HISTORICAL SUMMARY. 89 

island two hundred convicts. These criminals can be 
said to have b^en the pioneer settlers of the island. 

At Darien, in 1509, the expedition commanded by Da- 
vila lost seven hundred men in a single month. Panama 
had the same experience.^ 

Fathers Breton and Dutertre,^ who describe the epi- 
demic of 1635, in Guadeloupe, says that it was known 
among the Caribs b}^ the name of Poulicantlna, a word 
which signifies ''I am struck with a switch," which meant 
to describe the suddenness which characterized the onset 
of the fever. These same observers say that the disease 
was considered so infectious b}^ the natives, that those 
stricken were often abandoned to their fate and whole 
villages were deserted when the first cases appeared, the 
torch being applied by the terror-stricken Caribs, so as 
to prevent the further spread of the infection. 

Ziemssen's Cyclopedia of the Practice of Medicine^^ 
that wonderful storehouse of medical lore, which is edited 
with that careful attention to accuracy and to the 
minutest details which characterize the German mind, 
has the following observations on the subject: 

^'We are entirely without trustworthy information re- 
garding the first appearance of yellow fever. It is highly 
probable, that the communication of various authors, 
which inform us of the prevalence of the disease in the 
Antilles since the memory of man, really refer to yellow 
fever. The theory is much more tenable that the disease 
was first developed after the immigration of Europeans 
into the West India Islands; at least, it agrees better 
with many facts, which have been since observed, to con- 
sider yellow fever as an acclimation disease (of the 
tropics), to which immigrants are liable, than to assume 
that it originally prevailed as an epidemic disease among 
the natives, and afterwards underwent a complete altera- 
tion of its character. The Antilles were probably the 
cradle of yellow fever; at least, accurate observations of 
the disease in question were first made here." 

The Board of Experts authorized by Congress to in- 

®Du Tertre: Histoire General des Antilles, vol. 1, p. 30. 
^•^Vol. 1 (1874), p. 489. 



90 HISTORY OF YELLOW FLYER. 

vestigate the yellow fever epidemic of ISTS. after thorough 
and minute i-uTestigations. reached the following conclu- 
sions :^^ 

••Yellow fever was not known to the people of the East- 
ern Hemis])here until after the discoyerv of America by 
Columbtis. The earliest epidemics of which we have any 
historical information occtirred during the first half of 
the seventeenth century, in the West India islands." 

Joseph Jones, one of Louisiana's most distinguished 
physicians, whose works on fevers are acknowledged 
atithorities. makes the following observations :^- 

••After a critical examination of the works of Herod- 
otus^, Strabo, Jtistin, Cornelius, Xepos, Eutropius, Plti- 
tarch, Tittis, Linus, Thucidides, Homer, Salhist. Virgil, 
Flores. Vallerius, Particulus, C»sar, Horace, Cicero, 
Xencphon; and Tacittis. we have failed to recognize the 
disease now calleel yellow fever, in any descriptions of 
l)articular plagues or allusions to any pestilence; and in 
like manner, while in the writings of the middle ages we 
have descriptions of wide-spread and mortal plagties, 
amongst which may be recognized the oriental giandtilar 
plague, small-pox, measles, tyi^htis and typhoid fevers, the 
sweating sickness, elephantiasis or leprosy, cholera, 
dysentery, and cerebro-spinal meningitis: yellow fever 
finds no place in these annals of general history, or of 
medicine, previous tr> the discovery of America by Colum- 
bus. As we have failed to find any history or record of 
yellow fever before the voyage of Christopher Columbus, 
the first question of importance which presents itvSelf is, 
whether yellow fever had ever prevailed among the 
aboriginal inhaV)itants of North and South America and 
the We.vt Indies previous to the discovery of America and 
the explorations of the Spanish adventurers, and the es- 
tablishment of the Spanish. French. Portuguese, Dutch 
and English colonies?" 

Dr. Jones then goes on to say that the West India 
Islands and certain portions of Xorth and South Ameri- 
ca, as the Valley of the Mississippi. Mexico, Central 
" See Report, p. — 

"JoDes: Proceedings Louisiana State Medical Society. 1879, 
p. 54. 



HISTORICAL SUMMARY. 91 

America and Peru, appear to have been, at the time of 
their discovery by Europeans, peopled with a sufficiently 
dense population for the existence of those conditions 
upon Avliich the origin and spread of certain diseases de- 
pend. The Avholesale destruction of the native popula- 
tion by cruel Avars, and by still more cruel slavery, and 
by the introduction of certain diseases, as the small-pox, 
as well as the Avanton destruction of the pictorial Avorks 
by which the hieroglyphics of the more adA^anced nations 
of America might liaAe been deciphered, and the sudden 
and utter subA^ersion of the systems of religion and science 
peculiar to these people, and the rapid disappearance of 
the royal families and priests who Avere, as in ancient 
Egyi3t, tlie custodians of the national science and art, have 
involA-^ed in obscurity many subjects of great and lasting 
interest to the medical historian. 

The medical historian has only imperfect and doubtful 
data upon which to found an^^ opinion as to the nature 
of the epidemic and contagious diseases which afflicted 
the aborigines previous to the discovery of the AVestern 
Hemisphere. 

That the more populous nations of America Avere not 
exempt from diseases of an epidemic and jDestilential na- 
ture, has been Avell established. 

The pestilence called by the Mexicans ''Matlazahuatr' 
desolated the cities of the Toltecs in the eleventh century, 
and forced them to abandon Mexico, and to continue their 
migrations soutliAvard, and to the Avest and northAvest; it 
iuA^aded the populous cities of Central America, and a 
similar disease committed great raA^ages amongst the In- 
dian tribes which occupied the country between the 
mountains and the Atlantic coast a fcAV years before the 
landing of the Pilgrim Fathers. 

The Matlazahuatl, a disease closely resembling yelloAV 
fever, but Avhich is said to be peculiar to the Indian race 
of America, has seldom appeared more than once in a 
century; it raged in the elcA^enth century amongst the 
Toltecs, it made great raA^ages amongst the Mexicans in 
1545, 1576, 1736,^1737, 1761 and 1763, and amongst the 
Indians of the Atlantic coast in 1618 and 1619. 

According to Alexander Humboldt, the Matlazahuatl, 



9£ HISTORY OF YELLOW FEVER. 

altliougli pestilential in iis naTiire. and at^H-nded wirli 
hiemorrliage from the n'j>e and si'^marh. was distinLT from 
the Vomito Prieto, and was peculiar to the alMii^ines 
of America. The Spanish authors call this disease a 
plagtie. The following passage from Htimlx>ldt's • -Politi- 
cal Essay on ^N'ew Spain" appears tLi ernhndy all that is 
known with reference to the nature of the Matlazahuatl of 
the Mexicans : 

-The Matlazahuatl. a disease peculiar to the Indian 
race, seldom a^^pears more than once in a centui^y. It 
raged in a particular manner in 154:5. 1576 and 173'j. It 
is called a plague by the Spanish authors. As the latest 
epidemic tcK>k j^lace at a time when medicine was not con- 
sidered as a science, even in the capital, we have no exact 
data as to the Matlazahuatl. It bears certainly some 
analogy to* the yellow fever or black vomiting ; but it 
never attacks white people, whether Europeans or de- 
scendants from the natives. The individuals of the race 
of Caucasus do not appeal* subject to this mortal typhus, 
while, on the other hand, the yellow fever or black vomit- 
ing very seldom attacks the Mexican Indians. The i)rin- 
cipal site of the Vomito Prieto is the maritime region, of 
which the climate is excessively warm and humid : but the 
Matlazahuatl carries terror and destruction into the very 
interior of the country, to the central table-land, and the 
coldest and the most arid regions of the kingdom. 

"Father Forribio, a Franciscan, better known by his 
Mexican name of Motolina, asserts that the small-pox at 
its introduction in 1520, by a negro slave of Xarvaez, car- 
ried off half the inhabitants of Mexico. Toquemada ad- 
vances the hazardous r»pinicin that in the two Matlaza- 
huatl epidemics of 1515 and 1576, SOO.fioo Indians died 
in the former, and 2,000,000 in the latter. But when we 
reflect on the difficulty with which we can at this day 
estimate in the eastern i>arts of Europe the number of 
those whr» fall victims to the plague, we shall very reas- 
onably be inclined to doubt if the Viceroys Mendoza and 
Almanaza, governors of a recently conquered country, 
were able to procure an enumeration of the Indians cut 
off by the Matlazahuatl. I do not accuse the two monkish 
hi.storians of want of veracity^ but there is very little 



HISTORICAL SUMMARY. 93 

probability that their calculation is founded on exact 
data. 

^'A very interesting problem remains to be resolved. 
Was the pest which is said to have desolated from time 
to time the Atlantic regions of the United States before 
the arrival of the Europeans, and which the celebrated 
Rush and his followers look upon as the principle of the 
yellow fever, identical with the Matlazahuatl of the 
Mexican Indians? We may hope that this last disease, 
should it ever reappear in Xew Spain, will be hereafter 
carefully observed by the physicians. "^^ 

Humboldt further states that long before the arrival 
of Cortez there had almost periodically prevailed in New 
Spain an epidemical disease called by the natives Matlaza- 
huatl, which several authors have confounded with the 
Yomito or yellow fever. This plague was probabh^ the 
same as that which in the eleventh century forced the 
Toltecs to continue their • emigrations southwards. It 
made great ravages amongst the Mexicans in 1545, 1576, 
1736, 1737, 1761, and 1763; but as has already been ob- 
served, it differed essentially from the Yomito of Vera 
Cruz. It attacked few except the Indians or copper-col- 
ored race, and raged in the interior of the country on the 
central table-land, at twelve or thirteen hundred feet 
above the level of the sea. It is true, no doubt, that the 
Indians of the valley of Mexico who perished by the thou- 
sands in 1761 of the Matlazahuatl, vomited blood at the 
nose and mouth; but these hsematemeses frequently oc- 
curred under the tropics, accompanying bilious ataxical 
{ata.riqitcs} fevers; and they were also observed in the 
epidemical disease which in 1759 prevailed over all South 
America, from Potosi and Oraso to Quito and Popazan, 
and which, from the incomplete description of Ulloa, was 
a typhus peculiar to the elevated regions of the Cordil- 
leras. 

In summing up the result of his investigations. Dr. 
Jones says : 

"It is evident, therefore, that the origin of the American 
plague or typhus (vomito prietOy fievre jaune, yellow 

"Humboldt: Political Essay in the Kingdom of New Spain, 
vol. 1, p. 1j7. 



94 HISTORV OF YELLOW FEVER. 

fever) is involved in doubt, on account of the prevalence 
in the tropical and sub-tropical regions and temperate 
zones, both amongst the natives and foreigners, of some 
forms of malarial fever, often attended with jaundice, 
passive haemorrhages, and black vomit. If it could be de- 
termined at what time this terrible disease was clearly 
recognized bv the medical profession and historical 
writers as distinct from paroxsvmal malarial fever, and 
as dependent upon a specific catise or upon a combination 
of causes peculiar to itself, a firm ground for the discus- 
sion of its origin and of its relations to the native popula- 
tion, as well as to the foreign elements, would be estab- 
lished. But it is well known that many of the descrip- 
tions given by various authors will apply as well to the 
severer forms of paroxysmal malarial fever as to yellow 
fever, and also that the distinction of the one from the 
other has been the result of comparatively recent labors, 
and even at the present time there are not a few physi- 
cians who hold to the identity of both diseases in their 
origin and essential nature." 

Clemow^^ says that so far as a somewhat imperfect 
knowledge of the history of the disease enables us to 
judge, it seems certain that originally yellow fever was 
essentially an American disorder, and that though the in- 
fection has to some extent become domiciled on the African 
shores, it is more than probable it was originally brought 
there from South America or the West Indies. ' ''It is to 
be noted,'- continues this atithor, "that some writers have 
held exactly the contrary vicAv and believed that yellow 
fever was originally imported to the West Indies by means 
of infected negroes from Africa.^-^ The facts of history 
are, however, against this view, and there is much evi- 
dence to show that this fever was known in those part of 
America where it still prevails, even before the discovery 
of the continent by Europeans, and long before the trans- 

"Clemow: The Geography of Disease, by Frank J. Clemow, 

(3 903), p 520. 
"^ In 1699 an English vessel carrying slaves transported > ellow 

fever to Mexico from the Atlantic coast of Africa. Bat 

the disease was already endemic along the shore of the 

Gulf of Mexico G A. 



HISTORICAL SUMMARY. 95 

port of negroes from Africa to the West Indies began to 
be practised." 

Toner believes that the conceded home of yellow fever 
is the West Indies. ^^ 

Stille^" asserts that yellow fever unquestionably ori- 
ginated in the W>st Indies, where it was observed at St. 
Domingo at the end of the fifteenth century. It was then 
carried to Mexico and other localities bordering on the 
Gulf of Mexico, where it prevailed to a great extent in the 
seventeenth century. 

Finlay,^^ in commenting on the history of the disease, 
asserts that the remotest records about epidemic disease 
in the Old World fail to show that yellow fever, or any 
other malady presenting similar epidemiological features, 
had ever been observed previous to the discovery of 
America in 1492; while in the newly-discovered lands it 
soon became apparent that every expedition of European 
settlers that came to the Antilles or to the Spanish Main 
had to pay a heavy tribute to an unknown pestilence, dur- 
ing the first summers of their residence, suffering there- 
after no further trouble from the climate. 

About fifteen years ago, Drs. Finlay and Berenger- 
Feraud,^^ independently of each other, undertook minute 
historical researches regarding this ''unknown pestilence," 
and came to the conclusion that the disease mentioned in 
the old Spanish chronicles as the "peste," "contagio" or 
"epidemia," was no other than our modern yellow fever. 
They also reached the conclusion that at the time of the 
discovery of America the disease was endemic on the 
coast of Mexico, at the present site of Vera Cruz, as well 
as on the Atlantic site of the Isthmus of Panama, and on 
the Spanish Main along the coast of Colombia and Ven- 
ezuela, inhabited by the Carib Indians. 

^•^ The Distribution and Natural History of Yellow Fever in the 
United States, by J. M. Toner. American Public Health 
Association Reports, 1873, vol. 1, p. 359. 

" Stille: Medical Record, N. Y., 1879, vol. 15, p. 193. 

"Finlay: Reference Handbook of the Medical Sciences, Vol. 
8, p. 322. 

'' Ibid. 



96 HISTORY OF YELLOW FEVER. 

This view is also concurred in by Anders,-*^ who states 
that yellow fever first appeared at Barbadoes (West In- 
dies) in 1647 and was subsequently conveyed along the 
channels of commerce, until it became widely dissemin- 
ated. 

Even the old stand-by of every American school-boy, 
the venerated and verbcse ^^oah Yv^ebster,-^ has something 
to say on the subject. He tells us in all seriousness that 
yelloAv fever jDrevailed among the Indians of Canada and 
'Xew England in 1618, was again epidemic in 1716 and 
made spasmodic appearances among the noble sons of the 
forest at various stated periods. 

According to the report of Beyer, Parker and Pothier,-^ 
yellow fever has been endemic in Vera Cruz since 1509. 

Manson, whose work on Tropical Diseases is one of the 
classics of medical literature, does not consider the mat- 
ter of mtich importance, summing up the situation in a 
few words, simply stating that it is impossible to deter- 
mine from existing records whether it was originally an 
African or a West Indian disease.-'^ 

One of the strange freaks of yellow fever visitations is 
recorded by Stille,-^ who claims that the disease was in- 
troduced into Dutch Guiana in 1793 from the West In- 
dies. For a period of 37 years after this, it never invaded 
that province. At the end of this long period of immunity 
the colony sttffered from a new importation of the disease, 
which visited it anntially thereaft-er for ten sticcessive 
years, when it ceased and for the six following years failed 
to occur. It was then reintroduced by an infected vessel 
and spread more widely than before. 

At the time spoken of by Stille, Spain possessed by far 
the best and largest portion of the American continent, 
extending from the north of California to the Straits of 
Magellan — a space between 6,000 and 7,000 miles — and 

-'Practice of Medicine, by James M. Anders, (1899) p. 119. 
^ History of Epidemic and Pestilential Diseases, by NoaH 

Webster, vol. 1, p. 177. 
-Report of Yellow Fever Party No. 1, Yellow Fever Institute, 

p. 12. 
==* Tropical Diseases, by Patrick Manson (1903), p. 187. 
=' Medical Record, N. Y., 1879, vol. 15, p. 193. 



HISTORICAL SUMMARY. 97 

the system of commerce which prevailed then appeared 
to be eminently favorable to the origin and spread of yel- 
low fever. The Spanish galleons dotted the seas and, 
during times of peace (which were not frequent in that 
age of buccaneering and aggressive colonization) visited 
the principal ports of the Spanish Empire, where they 
were ahvays royally entertained. It was therefore easy 
for them to cavvj disease from one port to another, a fact 
which is attested by the melancholic record of the fearful 
epidemics which visited the New World in the early days 
of its history. 

Joseph Jones^^ thus interestingly describes the usual 
programme followed by the galleons : . 

''They sailed from Cadiz to the Canaries, thence for the 
Antilles, and after reaching this longitude the}' bore 
away for Carthagena. . As soon as they came in sight be- 
fore the mouth of Eio de la Hacha, after haying doubled 
Cape de la Vela, advice of their arrival was sent to all 
parts, that everything might be prepared for their recep- 
tion. They remained a month in the harbor of Cartha- 
gena, and landed there whatever was designed for terra 
firma. They then sailed to Puerto Velo, where, having 
stayed during the fair, which lasted five or six weeks, 
they landed the merchandise intended for Peru, and re- 
ceived the treasures and commodities sent from thence. 
The galleons then sailed back to Carthagena, and re- 
mained there till their return to Spain, which usually hap- 
pened Avithin the space of two years. When orders for re- 
turning home arrived, they sailed first to the Havana, 
and having joined the flota, and what other ships were 
bound to Europe, tliey steered nortliAvard as far as Caro- 
lina, and then, taking the westerly winds, they shaped 
their course to the Azores, when, having watered and 
victualed afresh at Terceira, they thence continued their 
voyage to Cadiz.-' 

What a glamour of romance and interest invariably 
surrounds the writings of this great son of Louisiana! 
The paragraph above cited almost carries one back to the 
good old days when men lived only to fight, eat, drink 

-''Jones: Transaction Louisiana State Medical Society, 1879, 
p. 64. 



98 HISTORY OF YELLOW FEVER. 

and write sonnets toi their lady-loves and cared naught for 
the morrow. 

But my enthusiasm makes me forget my task. Let us 
return to our mutton. 

In an interesting paper read by LeBeuf before the Or- 
leans Parish Medical Society, and published in the 
Transactions of that Society for 1905 and also in the 
New Orleans Medical and Surgical Journal for December, 
1905, a thorough review of the history of yellow fever is 
given. In commenting on the probable origin of the dis- 
ease, the doctor says : 

^'The Aztecs called the disease Matlazahuatl and Hum- 
boldt tells us that it existed as early as the eleventh cen- 
tury. In 1545, 1576, 1736, 1737, 1761 and 1777, it greatly 
deciminated the native Mexican race in a number of 
places. Before the advent of the white colonists it was 
not general. The natives travelled very little, on account 
of the lack of roads and the high mountain ranges. They 
had no vessels large enough to make the voyage to the 
West Indies and did not have free communication with 
outsiders. When the white colonists came, they were 
more susceptible to the dangers of the disease, as they 
were unacclimated, and were quickly the transmitting 
agent of it through all the low austral regions. It was 
also more fatal to them than to the natives, and it re- 
tarded the settlement of many calonies on account of the 
panics it caused." 

The same writer, quoting Prescott, says that it seems 
that European civilization carried with it the germ of 
the poison. The moment a town was founded or a com- 
mercial centre created, it was certain to cause the ex- 
plosion of the latent malignity of this poison in the air. 

We will conclude this resume of the American origin of 
yellow fever by quoting from that inexhaustible source of 
information. Dr. Joseph Jones :^^ 

''If it were possible to determine with accuracy the na- 
ture of the severe and fatal forms of fever which afflicted 
the first explorers and colonists of the tropical and sub- 
tropical regions of America, and even the very compan- 
ions of Columbus, the question of the origin of yellow 

^« Trans. La. State Med. Society, 1879, p. 63. 



HISTORICAL SUMMARY. 99 

fever would be relieved of much uncertainty and doubt. 
If we are to credit the accounts of some authors, the first 
trace of yellow fever was observed at the end of the fif- 
teenth and beginning of the sixteenth century at San 
Domingo and Porto Kico, in the Continent of South 
America, and in the Gulf of Darien, at which latter place 
it is said to have prevented the Spaniards from settling. 
In November, 1493, Columbus landed at San Domingo 
with 1500 Spaniards, in order to found the city of Isa- 
bella. A severe and fatal fever carried off the greater part 
of them within a year after their arrival, and the disease 
is described as being 'yellow as saffron or gold.' From 
1544 to 1568 there is no record of the disease having pre- 
vailed as an epidemic until 1635, when it appeared in 
Guadeloupe, and thenceforward it occurred at regular in- 
tervals. Tn the seventeenth century it spread along the 
Continent of South America to latitude 8° south, and 
in North America to latitude 42°, but only on the eastern 
coast of both. The first appearance of the disease in the 
United States was at Boston in 1693, and in Charleston 
and Philadelphia in 1699. It is said first to have appeared 
in the Gulf of Mexico, at Biloxi Bay in 1702, and Mobile 
in 1705; but Humboldt held that it had prevailed from 
the ver}^ foundation of Yera Cruz, and was indigenous to 
this city. It prevailed at Pensacola and Mobile in 1765. 

''In the eighteenth century it appeared on the west 
coast of South America in latitude 2° south. On the 
North American Continent it spread to latitude 42"; it 
extended even to Europe, and reached the Pacific and 
Madagascar. At the beginning of the nineteenth century 
it penetrated deeper into the North American Contin- 
ent than formerly, reaching as high as latitude 47° north, 
and in Europe it extended to latitude 48°, and prevailed 
in the Canary Islands and Leghorn. 

"Ever since yellow fever attracted attention it was 
recognizeci as a distinct disease from the remitent autum- 
nal fevers of the temperate zone. It has prevailed as an 
endemic in Havana, raging epidemically from April to 
December, and occurring sporadically during the rest of 
the year. From time immemorial it has been endemic at 
Vera Cruz, in the Gulf of Mexico, where its chief victims 



100 HISTORY OF YELLOW FEVER. 

are strangers who come from cold regions during the hot 
season, as well as Europeans and those native who ex- 
change the more elevated and cool regions of Mexico for 
the coast." 

African Origin of Yellow Fever. 

The doctrine that Africa was the original home of yel- 
low fever has been promulgated by many writers. 

As early as X815, Pym, in his ^'Observations on Bulam, 
or Yellow Fever," propagated the doctrine that yellow 
fever was endemic to Africa, had always existed there and 
that the world was indebted to that continent for the 
spread of the disease to the four points of the compass. 
This theory was warmly espoused by Audouard in the 
Revue Medicale (Paris, 1825), Avho thickened the plot by 
fastening the onus on the slave trade of colonial days and 
asserting that the disease also developed spontaneously 
in the holds of ships packed with living cargoes of slaves, 
reeking with filth and germ-propagating material. These 
views were seriously championed by many writers, one of 
them being that distinguished Louisiana authority on yel- 
low fever, Faget, who, in his work entitled Etudes Medi- 
cales de Questions Importantes pour la Louisiane, pub- 
lished in 1859, speaks in eulogistic terms of the views of 
Pym and Audouard and gives as his opinion that the 
theory advanced by these famous contagionists is the only 
rational solution of the problem. 

In support of his contention. Dr. Faget claims that 
when the traffic in slaves Avas interfered with by the 
United States government and the channels of this com- 
merce changed to sub-tropical ports, yellow fever, for the 
first time, broke out in Brazil. The learned doctor, in 
making this assertion, evidently overlooked the great epi- 
demic which broke out in Pernambuco in 1688 (according 
to Ferreira da Rosa) and which ravaged the Brazilian 
coast for several years afterAvards. 

In an interesting little book published in 1898, Cole- 
man (History of YelloAV Fever, etc.) revives the doctrine 
enunciated by Audouard, citing many examples in an ef- 
fort to prove that the French observer Avas correct, but 
advances nothing decidedly noA^el or couAdncinu'. 



HISTORICAL SUMMARY. 101 

According to Byrd,^^ the disease was introduced into 
Southern Europe, the West India Islands and the con- 
tinent of North and South America from the West coast 
of Africa, ''AYhere it originally flourished." This author 
blames the importation of the disease into Europe upon 
the ambition for extended territory which dominated the 
Caucasian race in the Middle Ages and holds the view that 
if the avarice and cupidity of the New England slave- 
trader had not tempted him to invade the jungles of West 
Africa, to kidnap the unwary and guileless aborigines, 
there is reason to believe that the hecatombs which have 
marked the visitations of the pestilence in the West In- 
dies and the shores of the American Continent, would 
never have been known. The natives of those lands knew 
nothing of the disease until brought to them by ships en- 
gaged in a most unholy commerce. 

Kochefort, one of the earliest writers on the subject, al- 
luding to the West Indies, says : ''This noxious air was 
brought by vessels coming from the African Coast. "^^ 

Another disciple of the African origin of the disease is 
found in Turpinseed,^^ who says that the great difference 
of temperature between day and night in the great desert, 
the air being 174° by day and 24° by night, undoubtedly 
had an influence in furnishing the embryonic conditions 
necessar}^ to the origin and propagation of the disease. 
The infection was then carried by the desert winds to the 
coast towns of West Africa and thence scattered to sus- 
ceptible foci throughout the world. 

Strobel,^^ who also blames Africa for having been the 
original source of infection, furnishes considerable in- 
formation concerning the origin and spread of yellow 
fever, but his views are, unfortunately, too biased to be 
of any reliable historical value. The learned essayist cites 
only events which lend color to his rabid views on conta- 
gion and he eludes facts Avhich prove the contrary in such 

-•Philadelphia Medical Times, 1872, vol. 3, p. 726. 

-® Ce mauvais air y avait ete apporte par des navires qui 
venoient de la Coste d'Afrique. Histoire Naturelle et 
Morale des Isles Antilles d'Amerique (1658), vol. 1, p. 3 

^^''Turpinseed: Medical Record, N. Y., 1878, vol. 14, p. 304. 

•■"Strobel: An Essay on the Subject of Yellow Fever, 1840. 



102 HISTORY OF YELLOW F£VER. 

a tactfnl and unconcerned way. that it is a pity Ms efforts 
should not have been directed to a better purpose. He 
deplores the fact that the French Academy awarded 3Ion- 
sieur Chervin a premium of 10.000 francs for his admir- 
able I this is our word, not Strobel's ) treatise on the non- 
contagiousness of yellow fever, and holds up Dr. Bahi as 
a martyr because the latter was chased out of Barcelona 
for having propagated the doctrine that the fever which 
prevailed in that city in 1S21 was contagious. -They ex- 
ecratel and threatened with death those physicians suffi- 
ciently well-informed to recognize this character of the 
disease," continues Strobel ; "'they called them, by way of 
insult and derision, the aiitJtors of yellow fever."'^^ i The 
italics are Strobel's. i 

But it is not our purpose to quarrel with the views of 
the respected and departed disciple of Bally, who was, we 
feel certain, honest in his opinion. TTe simi)ly desire to 
say. en passant, that Monsieur Chervin earned those 
10.000 francs by a large mai*gin, for it is of record that 
he not only put on the linen of patients that had died of 
yellow fever and slept in their beds, but that he also ate 
of the black vomit and inoculated himself with it. in order 
to prove the non-contagiousness of the disease. '^- 

Dowell-^^ speaks in positive terms concerning the source 
of yellow fever, giving Afi^ca as the undoubted origiQal 
focus. He also states that it exLsted in Africa, Eastern 
Asia, and Southern Europe, long before the establishment 
of the Greek and Eoman Empires, even running back a 
thousand years before Christ. 

Chisolm was an advocate of the African importation of 
the disease, as will appear by a perusal of his work pub- 
lished in 1799.^^ 



=»Ibid, p. 8. 

- Lancet, 1849, vol. 2, p. 433. 

*^Doweli: Yellow Fever and Malarial Diseases, etc.. 1S76. p. 
13- 

** Chisolm; An Essay on the Malignant Pestilential Fever in- 
troduced into the West India Island from BouUam, etc, 
1799. 



HISTORICAL SUMMARY. 103 

Sternberg^^ says that the early history of the disease is 
involved in obscurity and it is not possible to determine 
whether, as maintained by some, it was endemic at certain 
points on the shores of the Gulf of Mexico at the time 
of the discovery of the New World, or whether it was im- 
ported to the West Indies from the African coast, as ad- 
vanced by others. 

In commenting on the African theory of the origin of 
the disease, Sternberg adds that it seems very probable 
that the pestilential malady which prevailed for a time in 
these usually healthy islands (the West Indies) and then 
disappeared, was in fact yellow fever, and that it was in- 
troduced by ships from the west coast of Africa is not at 
all incredible. ^'Indeed," continues this authority, ''it al- 
most seems necessary to look for an endemic of the dis- 
ease outside of the West Indies, for the reason that in the 
comparatively few places in which it is now endemic, 
there is historical evidence to show that there was first im- 
portation and a previous period of exemption; while, on 
the other hand, the conditions upon which endemicity at 
the present day seems mainly to depend, were formerly 
unknown — conditions arising from the aggTegate of popu- 
lation at seaport cities, as in Havana, Vera Cruz and Kio 
Janeiro. "^^ 

Elliott,^'^ in commenting on the endemic diseases of 
West Africa, says : ''There is an old doctrine that yellow 
fever had its original home on the West African coast, and 
that its existence in the tropical regions of the American 
continent and in the West Indies is the result of the 
slave trafiic. On the other hand, certain French authors, 
notably Berenger-Feraud, contend that the disease was 
first imported into Africa from America. However this 
may be, there is no doubt about the fact that yellow fever 
has frequently shown itself in epidemic form in Senegam- 
bia, and that the British possessions on the West African 
littoral are liable to outbreaks of a peculiar malignant 

^^ Sternberg: Reference Handbook of the Medical Sciences, 

vol, 8, p. 583. 
3« Ibid, p. 584. 
"Elliott: Journal of Tropical Medicine, London, 1899, vol. 1, 

p. 317. 



104 illSTORY OF YELLOW FEVER. 

form of fever which is confined to the European residents, 
and which, after thinning their numbers to an appalling 
degTce, and within a brief period, suddenly disappears." 

It is a matter of history, and cannot therefore be contra- 
dicted with any degree of safety, that in December, 1493, 
when Columbus reached St. Domingo, bringing with him 
the first Europeans who had ever set foot on American soil 
(about fifteen hundred, according to Cornilliac^^) that 
a pestilential disease broke out in the Tillage of Ysabella 
(then in process of construction), and nearly annihilated 
the venturesome little band that had braved the terrors of 
a long voyage through unknown seas to colonize a strange 
and wonderful land, where, according to the fabulous 
stories then current, ^'gold grew on trees and diamonds 
strewed the ground." 

Pouppe-Des-Portes,^^ a French surgeon, who practiced 
at St. Domingo from 1732 to 1748, says that yellow fever 
was quite prevalent in the West Indies at that time and 
was called Mai cle Siam, from the tradition that it had 
first been observed at St. Domingo during the visit of a 
French man-of-war coming from the kingdom of Siam in 
the seventeenth century. 

No one who has read the works of Bally will dispute 
the fact that he is generally reliable and accurate in his 
statements, but his unalterable belief in the doctrine of 
contagion and importation made him blind to the true 
state of affairs in this particular instance. Even such an 
eminent authority as LaRoche criticizes the great apostle 
of contagion, observing that the course he pursued in the 
controversies about his pet theory was assuredly not com- 
mendable.^9 

In this connection, it is opportune to remark that up 
to 1793, a majority of American physicians were believers 
in the contagiousness of yellow fever, but during the epi- 
demics occurring between that date and 1825, the practi- 
cal experience so changed the mind of the medical world, 
that, while five hundred and sixty-seven were against the 

^' Pierre Martyr, in his "Decades/' says the number was 1200. 
■•" Histoire des Maladies de A, St. Domingue, vol, 1, p. 191. 
"Americ*\n Journal of the Medical Sciences, April, 1853, p. 317. 



HISTORICAL SUMMARY. 105 

doctrine of contagion, twenty-eight only remained in fa- 
vor of it."^^ 

The phj^sicians of two hundred years ago Avere just as 
bitter and acrimonous when it came to discussing the 
subject of 3'ellow fever as those of our present enlightened 
age. A glance over the pages of the Medical Repository, 
the Edlnhiirg Medical Revieio, the British and Foreign 
Medico-Chirurgical Revieto, and other old-time medical 
journals, reveals page after page of decidedly personal re- 
marks directed by some venerable Esculapius against a 
brother who held a contrary view to those which were, in 
his opinion, the only tenable way of explaining certain 
things. The amount of vituperative ammunition which 
those ancient disputants possessed certainly puts all mod- 
ern efforts in that line in the shade. The terms ''medical 
buccaneers," ''malignant drivelers," "inexperienced and 
transient practitioners," etc., were among the lukewarm 
expressions used in these amiable diatribes. 

Sometimes, finding discussions through the medical 
press too tame or monotonous, the disputants abandoned 
the quill for more strenuous modes of clinching an argu- 
ment and we find mention here and there of violent per- 
sonal encounters between opponents of contending theo- 
ries. One of the most remarkable ways of settling a dis- 
pute concerning the diagnosis of yellow fever, took place 
at Kingston, Jamaica, between Drs. Williams and Ben- 
nett, who met on the field of honor on the 29th of Decem- 
ber, 1750, and fought so ferociously that they finally suc- 
ceeded in killing each other.^^ 

Asiatic Origin of Yellow Fever. 

An anonymous writer, more audacious and original 
than his contemporaries or those who lived before him, 
and whose identiy, unfortunately, we have been unable to 
unravel, asserts that the ancient and malodorous city of 
Smyrna, in Asia Minor, was the original focus whence 
yellow fever infected the world, and cites in support of 
his theory certain passages of history referring to the re- 

" Dowell, p. 107. 

*- Medical Repository, N. Y., 1805-06, vol. 9, p. 187. 



106 HISTORY OF YELLOW FEVER. 

mittent fevers which devastated the Grecian Archipelago 
and the shores of Asia Minor as far back as the age of 
Pericles. 

French writers of the seventeenth century adhered to 
the theory that the Typhus miasmatiqiie ataxique putride 
jaune, the name by which the disciples of Bally desig- 
nated yellow fever, had its origin in Siam. Bally^^ as- 
sures us that the disease was brought to the island of 
Martinique by the ship of war VOriflamme in 1682, in 
which year *'the French people who had settled in Siam 
fled from the insurrection in that country and established 
themselves at Fort Eoyal/' Bally also states that the 
Oriflamme stopped at some Brazilian port on its way to 
Martinique. According to Ferreira and others, yellow 
fever was epidemic in Brazil at the time spoken of by Bal- 
ly, and if such was the case, how could the disease have 
been imported from Siam, when it was already implanted 
on American soil? There is certainly a historical faux- 
pas somewhere. 

Moreau de Saint-Mery, one of the most reliable and 
learned chroniclers of his time, in commenting on the al- 
leged Siamese importation, makes certain observations 
which leave no doubt that the disease brought to Martin- 
ique by the Oriflamme was yellow fever, no matter where 
the original infection of the vessel took place. Accord- 
ing to this authority, the ship was a hotbed of disease 
when it reached Martinique. Spotted fever {le pourpre, 
to use his exact expression) and an unknown pestilen- 
tial fever had committed fearful ravages among the ofift- 
cers and crews of the ill-fated Oriflamme, the mortality 
exceeding one hundred souls, among the victims being 
McRisieur de Lestrille, the commandant of the expedition. 
Saint-:\Iery also speaks of the bloody uprising which took 
place in the Siamese Empire and the flight of the French 
settlers on board the ships VOriflamme, Le Loiitre and 
the aS7. Nicholas, which set sail for France with all possi- 
ble haste. When the miniature flotilla entered the Atlan- 



•^ Description Topographique, Physique, etc., de I'lle de St. 

Domingue, by Victor Bally (1814), p. 700. 
** The distinguished contagionist evidently got his dates mixed, 

as the insurrection in Siara took place in 1688. G. A. 



HISTORICAL SUMMARY. 107 

tic Ocean, it was diverted from its course by storms, com- 
pelling the ships to make for the west. The Oriflamme 
arrived safely at Fort Koyal, Martinique, but the fate of 
her sister ships is left in doubt. Nowhere does Saint- 
Mery speak of the vessel having touched at any port in 
Brazil, as asserted by Bally and those cited by him. The 
date given by Saint-Mery (1690) is certainly more accu- 
rate than that stated by Bally (1682), as a reference to 
the political history of Siam, reveals the fact that the mas- 
sacre of the handful of Englishmen in the factory at 
Ayuthia, then capital of the kingdom, which was the sig- 
nal for the anti-foreign demonstration which put an end 
to the intrigues of the French court, took place in 1688. 

Cornilliac^^ gives 1690 as the date of the arrival of the 
Oriflamme at Martinique. 

Father Labat, a Dominican friar, who arrived in Mar- 
tinique in January, 1594,^^ tells of the ravages of the dis- 
ease, which he claims was imported by the warship 
VOriflamme, which had touched at a Brazilian port on its 
way from Siam. 

What led additional color to the story of the disease 
having been imported from Siam, was the fact that, in 
1691, two vessels arriving from Pondichery, capital of the 
French East Indian settlement of that name, in Siam, 
were found to be nests of yellow fever, Avhich caused an 
appalling mortality among the crews of both vessels. It 
was afterwards proved, however, that the infection had 
been contracted at Fort Royal. 

Whether or not the disease was imported to the West 
Indies from Siam, or vice versa^ is a point which we will 
leave for others to dispute and theorize upon; but the 
importation, if it ever happened, certainly did not take 
place for the first time either in 1682 or 1690, as the reli- 
able and unassailable records of such historians as 
Oviedo y Valdez, Gomora, Coreal, Humboldt, Ulloa, Cor- 
nilliac, and Rochefort, give details of epidemics which de- 
vastated the West India Islands as far back as the 

^'' Recherches Chronologiques et Historiques sur TOrigine et la 
Propagation de la Fievre Jaune dans les Antilles, by 
Cornilliac (1867), vol. 2, p. 72. 

«Ibid., p. 73. 



J 08 HISTORY OF YELLOW FEVER. 

fifteenth century. We are more inclined to lean to the 
theory that the disease was first brought to the East from 
the tropical coasts of America. 

Moseley^^ speaks at length of the ravages committed 
by the fever at Martinique in 1665 and the majority of 
authors of the time concur in saying that, although yellow 
fever prevailed in the West Indies ever since the voyages 
of Columbus, there is no authentic instance of the disease 
having been noticed on vessels previous to 1690, when the 
Oriflamme incident set the whole medical world agog. 
On the contrary, these ancient writers agree in the opin- 
ion that yellow fever prevailed as an endemic in the sev- 
enteenth century in all the localities in the New World 
bordering on the Gulf of Mexico and the Atlantic shores 
of South America, almost as far South as the Rio de la 
Plata. 

We will conclude by quoting from Hillary (Observa- 
tions on the Changes of the Air, etc., London, 1759), p. 
144 : ''We observe no trace of this scourge in the descrip- 
tions given by ancient writers, not even by the Arabian 
observers, who practiced in warm climates." 

So far as history informs us, yellow ^fever has never 
been observed in Asia, although this vast continent is 
studded with regions which possess all the requirements 
for engendering and spreading the disease, including the 
Stegomyia. Let the Panama Canal be pierced, however, 
thus reducing time of commercial intercourse between the 
West Indies and the East to a fcAV days, and we shall, in 
all probability, see yellow fever transplanted to these 
ancient shores and commit fearful ravages among its bil- 
lions of souls. 

This is not a fanciful flight of the imagination, but 
simply a ''look forward," a calm, dispassionate prophecy, 
based upon experiences of the past and whose ultimate 
truth will thrill humanity with horror and despair when 
the mists which veil the future have melted away. 

The Gulf Stream Theory. 

Professor P. Stille, of Mobile, differs from all the pre- 
ceding authorities, and advances a novel theory to ac- 

-^A Treatise on Tropical Diseases, p. 421. 



HISTORICAL SUMMARY. 109 

count for the origin of yellow fever. He attributes it to 
the Gulf Stream. Calling attention to the equable atmos- 
pheric conditions of the tropical lands of both hemi- 
spheres, he says : ''Coming up the south-east, across the 
torrid zone, is an ocean current which, where it sweeps 
around the north coast of South America, is called the 
Guiana Current. It makes its way directly into the Gulf 
of Mexico, where it takes the name of the Gulf Stream. 
After washing the smaller islands of the West Indies, it 
forces itself with great strength through the narrow chan- 
nel between Cuba and Yucatan, and rushes all around 
the shores of the gulf, taking its turn towards the east, 
and quitting the land immediately after passing the 
southern point of Florida. Within the gulf its tempera- 
ture stands at from 85° to 89°, but soon after having 
passed Florida its temperature goes suddenly clown to 65°, 
and finally to 54°, and 50°. Now, if we examine every 
part of the sea we shall find no other spot where a warm 
current washes the land at an^^thing like so high a tem- 
perature as is exhibited in the Gulf of Mexico. A; goodly 
portion of the time the temperature of the water stands 
entirely above that of the air, consequently a heavy mist 
is taken up. In other words, the atmosphere is com- 
pletely saturated with moisture to such an extent as to 
render it too heavy to rise in obedience to the usual laws 
governing evaporation, the high temperature of the land 
preventing condensation. As a result, there lies upon the 
surface of the low country a thin stratum of air so heavy 
and so damp as to tempt us strongly into coining suba- 
queos as a designation by which to represent its condi- 
tion. For proof that such conditions do arise in all 
cases where the Avater stands at a temperature higher 
than that of the air, we refer you to Fitches' Physical 
Geography, page 152 ; and for proof that they exist in the 
West India Islands, see Humboldt's Island of Cuba, page 
172. And here, in my humble judgment, we have arrived 
at a knowledge of the main conditions necessary to the 
propagation of the yellow fever: ^A stratum of atmos- 
phere saturated with moisture to such an extent as can 
only occur urder like circumstances as exist in the West 
Indies, and a tropical clime such as prevails there, and is 



110 HISTORY OF YELLOW FEVER. 

every now and then, as I contended, carried into regions 
far above its natural lines. This thin stratum of heavy 
atmosphere is carried from the ocean equator and thrown 
upon our shores from the gulf breezes, so called, but in 
ordinary seasons the low temperature of the earth con- 
denses the moisture permanently before it has passed far 
inland. In seasons like the present, however, when there 
have been two summers together, as it were, the earth with 
us is too warm to admit of permanent condensation. A 
portion of the moisture may fall as heavy as dew, but the 
rising temperature of the morning will take it up again, 
and hence it will be carried on, wave after wave, as it 
were, until it has reached its final stopping place, possibly 
many degrees above the shore of the Gulf of Mexico. The 
immediate agent working in yellow fever (be it living 
atom or fungus) is semi-aquatic in its nature, perhaps, 
and therefore always finds itself a home in this peculiar 
character of heavy and wet atmosphere; hence it flour- 
ishes wherever a footing can be secured in it; and fattens 
upon its human victims the more the further it gets from 
its nursery bed and finds them the less acclimated against 
its effects. This heavy atmosphere theory would explain 
whv vellow fever is mainlv confined to the low errounds — 
in all cases waves of heavy atmosphere, like currents of 
water, find their ways through the depressions upon the 
surface of the earth. If our Gulf breezes should drive 
them inland, they would very naturally roll up the valleys 
of our rivers.'' 

Prof. Stille was without doubt one of the South's fa- 
mous sons and a scholar of recognized ability, but his 
theory is decidedly untenable, especially when viewed 
through twentieth century spectacles. A reference to the 
medical part of this volume, where will be found practi- 
cal and scientific arguments concerning the origin and 
spread of yellow fever, will be sufficient to remove any 
doubt which the skeptical reader may entertain in the 
premises. We have given a place in this work to Prof. 
Stille's theory, not because we endorse or admire it, but 
simply to put it on record among the many odd views ad- 
vanced concerning the oric^in of vellow fever. It is a 



HISTORICAL SUMMARY. Ill 

close second to the views of the College of Physicians of 
Paris, published in a preceding chapter. 

Observations by the Author. 

Emerging from the heterogenous avalanche of opinions 
promulgated by sedate and learned chroniclers of ages 
past and present, bewildered by the positiveness of each 
and every argument advanced to prove that yellow fever 
originated anywhere except in the natal land of the ob- 
server, we pause for a moment on the threshold of trepi- 
dation before making a digest of the theories advanced in 
the foregoing pages. We stop just to take a breath, rivet 
the wobbling places in our armor, and then rush into the 
fray with the satisfaction that we will at least make the 
situation still more unintelligible. 

The West Indian Theory. — We are free to confess 
that we see much to admire and theorize upon in the doc- 
trine that yellow fever is a West Indian product. Look 
into the history of every notable epidemic and you will 
see that ''a ship from the West Indies" carried the infec- 
tion. Of course there are exceptions, but they are few. 

A search through the works of Oviedo, Pierre Martyr 
d'Anghiera, Fernand Columbus (a son of the great dis- 
coverer), Herrera and other early writers, reveals the 
fact that yellow fever attacked the Spaniards, English, 
French, Dutch and Portugese wherever they tried to es- 
tablish themselves in the New World. In the following 
table, we give the first four historic outbreaks of yellow 
fever in the West Indies. We have purposely selected ex- 
amples where the scourge manifested itself within a few 
months after the landing of the colonists, as this is all 
that is needed to illustrate the point we wish to em- 
phasize : 



112 



HISTORY OF YELLOW FEVER. 



First Eecorded Outbreaks of Yellow Fever in the 

West Indies. 



Island 



Locality 



U5 

*J c 


^^\ 


^ G a 


^ s s 








"^2 


^ 


cZ-S 



REMARKS 



San 
Domingo 



Porto Rico Capara 



Ysabella, 



1493 



Jamaica 



Sei'illa 
llMelilla 
HOristan 



1508 



1509 



Gaude- St. Pierre 1635 

loupeJUGrande j 
Ansel 



1493 



1508 



1635 



Ysabella was the first town established in the 
Western Hemisphere by Europeans, being- found- 
ed by Christopher Columbus in December 1493, 
fourteen months after the discovery of America. 
That same month the colonists were attacked by 
a pestilential disease (now known as yellow fever) 
which raged until 1496, when the town was aban- 
doned. 



Capara, founded by Ponce de Leon in 1508, Was 
abandoned the same year, owing to the ravages 
of the *' unknown pestilence." 



Sevilla was founded by Diego, a son of Colum- 
bus, in 1509. The Yellow Spectre soon invaded 
the place and the inhabitants fled in terror to 
the north of the island, where they built the town 
of Melilla. The pestilence pursued the colonists 
into their new abode and they again fled, this 
time to the southern p rt of the island, where, for 
a third time, they launched a new town lOristan). 
Like its predecessors. Oristan was soon laid waste 
by the same terrible disease which has to this 
day been the curse of the Antilles. 



In 1635, L'Olive and Duplessis, agents of the 
French Government, with a following of 550, 
founded the towns of St. Pierre and Grande Anse. 
Three months after the arrival of the colonists, 
yellow fever made its appearance, Duplessis him- 
self dying of the scourge. The epidemic devasted 
the island from 1635 to 1652, a period of seventeen 
years. 



Some doubtful Thomas will probably shrug his 
shoulders and ironically ask us to explain how it is that 
Columbus and his intrepid sailors Avere not attacked bv 
yellow fever when they set foot on the Island of San Sal- 
vador, if the theory of Antillian endemicity of the dis- 
ease is correct. 

It is not necessary to call into action Eooseveltian pow- 
ers of reasoning to explain this. 

The discoverer of the New World and his followers es- 
caped an attack on their first voyage for the reason that 
they landed on the Island of San Salvador during the cool 
season (October 12, 1492), at a time when mosquitoes 



^ HISTORICAL SUMMARY. 113 

were inactive ; tliat they did not mingle much with the na- 
tives and, finally, that they confined their explorations to 
the coasts and did not venture into the interior of the 
"unknown country" which was destined to change the 
whole political aspect of the then known world. 

On the second voyage of Columbus things were differ- 
ent. The Europeans landed hundreds of miles further 
South (San Domingo), at a place where the breath of 
Boreas is never felt, and found all the conditions neces- 
sary to contract the disease, including the Stegomyia 
Calopus. Frequent intercourse with the natives, 
fatigues, privations and exposure, rendered the new- 
comers easily susceptible to the germs which were only 
awaiting new fuel to kindle the fires of pestilence anew. 
And, from that date, wherever the Spaniards went, the 
jaundiced handmaiden of death — yellow fever — was 
awaiting their arrival. 

The African Theory. — It does not require a profuse 
waste of gray matter to relegate the African theory of 
the origin of yellow fever to the oblivion it richly deserves. 

In looking over the literature on the subject, we notice 
that even such a learned author as Berenger-Feraud was 
nearly converted to the doctrine of African endemicity, 
being somewhat inclined to believe that the epidemics in 
Senegal Avere of spontaneous origin. But he guarded his 
views with the statement that he was not totally convinced 
and, in a later article, showed the absurdity of this doc- 
trine. 

We believe, like Berenger-Feraud, that the African 
theory is untenable and easily disproved. The West 
Coast of Africa has been known to Europeans ever since 
the sixth century Before Christ, when, Hammo, a Car- 
thagenian, made a voyage along that coast and is said to 
have got as far as the Bight of Benin. The Portugese, 
however, were the first people of modern times to under- 
take the exploration of the Dark Continent. In 1433, 
they doubled Cape Bojador, in 1441 reached Cape Blanco, 
in 1442, Cape de Terde, and in 1462 discovered Sierra 
Leone. In 1484, Diego Cam, an audacious Portugese 
navigator, discovered the mouth of the Congo. That 
same nation established the first European settlement in 



I 14 HISTORY OF YELLOW Fi:VER. 

Africa at Angola about the year 1500, eight years after 
the discovery of America by Columbus. 

From the inception of its colonization, the commerce 
between Africa and Europe was an active one, and had 
yellow fever been endemic in the Dark Continent at the 
time it Avas first visited by Europeans, the disease would 
certainly have been imported by the ill- ventilated and un- 
sanitary craft engaged in this primitive intercourse and 
would have caused memorable epidemics in Europe, which 
would have been noted by the historians of the period, 
who had a knack of writing about everything and every- 
body, no matter how trivial or private. It is a matter of 
history, chronicled by many w^riters, that it was only after 
the discovery of America that yellow fever was observed 
in Africa. The first authentic account is that of the voy- 
agers Windham and Pinteado, who speak of having ob- 
served yellow fever on vessels off the coast of Benin in 
1558. This is not at all improbable, as slave-hunters from 
the Spanish colonies in the New World frequented, the 
coast of Africa as early as the middle of the sixteenth 
century, to replace with negroes the dearth of labor caused 
by their massacres of the Indians in Cuba, Mexico and 
South America. After stealing the gold which the Aztecs 
and Incas had taken centuries to amass, the Spaniards 
forced their victims to work their mines and till their 
plantations. Unused to such toil, which was rendered 
still more onerous by the cruelties practiced upon them by 
their conquerors, the Indians perished by millions. His- 
torians tells us that more than half the population of 
Peru were consumed in the mines. 

AVafer, an English surgeon (according to Moseley^^), 
says that he and some others landed at Vermejo, in Peru, 
in 1687, and marched four miles up a sandy bay, ''all of 
which," he says, 'Sve found covered with bodies of men^ 
women and children, which lay so thick, that a man 
might, if he would, have Avalked half a mile and never trod 
a step off a dead human body. These bodies, to appear- 
ance, seemed as if they had not been above a week dead ; 
but if you handled them, they proved as dry and light as 
a sponge, or piece of cork." The voyagers soon came upon 
^' Moseley: A Treatise on Tropical Diseases, 1792, p. 155^ 



HISTORICAL SUMMARY. 115 

a Spanish Indian, who was picking up dried soa-weed, and 
asked him how those dead bodies came there? To which 
he answered that, in his father's time the soil, 'Svhich 
now yielded nothing, was green, well-cultivated and fruit- 
ful; that the city of Wgrniia had been well inhabited by 
Indians; and that they were so numerous, that they 
could have handed a fish, from hand to hand, twenty 
leagues from the sea, until it had come to the Inca's 
hands; and that the reason of those dead bodies was, 
that when the Spaniards came and blocked up and laid 
seige to the city, the Indians, rather than lie at the 
Spaniards' mercy, dug holes in the sand and buried them- 
selves alive." 

When the Spaniards saw that the natives were about 
to become extinct, and that the majority of those that 
were left had fled to caverns and mountain fastnesses, 
they had recourse to Africa, and negroes were imported 
by the thousands to take the places of the Mexicans, Peru- 
vians and West Indians. This Avas the beginning of the 
slave trade, and the constant voyages to and from Africa 
in quest of new victims, gave a semblance of truth to the 
theory that yelloAV fever had been imported from Africa 
to America. 

Let us now juggle with dates and obtain some poignant 
conclusions : 

A glance at the table on page 112 will show that the first 
epidemic of yellow fever in the world of which there is 
any record took place at Ysabella, San Domingo, in De- 
cember, 1193, fourteen months after the discovery of 
America. According to Lind, the first outbreak of yellow 
fever on the mainland of Africa took place in Senegal in 
1759, two hundred and sixty-six years after the Ysabella 
incident. As the mainland of Africa was colonized hy 
Europeans about the year 1500, and yellow fever was 
never observed prior to 1759, or two hundred and fifty- 
nine years after its colonization, it is not necessary to in- 
dicate with a i^ointer on the map of the world where the 
natural home of yellow fever was, is and will continue to 
be for all time to come— unless our Southern neighbors 
stop long enough launching new revolutions and attend to 



116 HISTORY OF YELLOW FEVER. 

intelligent preventive measures against a disease which 
science has proved can be conquered. 

Ainother noteworthy fact before we conclude: 
The epidemics of yellow fever in the West Indies fol- 
lowed one another in rapid succession and hardly a year 
has jDassed since 1493 without the disease manifesting 
itself, either sporadically or as an epidemic, in one of the 
Antilles. In Africa, the record is different. 
Let us take Senegal to illustrate our point : 

From 1759 to 1882, a period of one hundred and twenty- 
three years, there were six epidemics in Senegal. Be- 
tween the first and second epidemics (1759-1778), nine- 
teen years elapsed; between the second and third (1778- 
1830), fifty-two years; between the third and fourth 
(1830-1867), thirty-seven years; between the fourth and 
fifth (1867-1878), eleven years; between the fifth and 
sixth (1878-1882), four years. 

By reference to the chronological tables in another 
part of this volume, it will be seen that during this same 
period of one hundred and twenty-three years, there is a 
record of nearly two hundred outbreaks of yellow fcA^r in 
the West Indies. 

A soil which can produce yellow fever will do so annu- 
ally; the long intervals between the epidemics in Africa 
gives the palm to the West Indies. 

The Ship Theory. — The theory that yellow fever 
originates on shipboard was based on the fact that, in sev- 
eral notcAvorthy instances — such as the outbreaks at St. 
Nazaire, Brest, Falmouth, etc. — it Avas noticed that so 
long as the hatches remained -closed, the disease did not 
manifest itself, but as soon as the scuttles and hatches 
Avere opened, the fever invaded the A^essel and often spread 
to the port Avhere she Avas riding at anchor. 

This is easily explained: The infected mosquitoes, 
Avhich had fed on yelloAv fcA^er patients at the port of sail- 
ing, had been imprisoned in the hatches during the long 
voyage across the seas, Avith no chance of gaining access 
to the upper parts of the ship. When the vessel reached 
her destination and the hatches were opened, the insects 
were liberated and SAvarmed with famished haste all OA^er 
the vessel, inoculating Avith the poison of yellow fever 



HISTORICAL SUMMARY. 117 

every susceptible person they bit. These persons, in turn, 
were so many new foci of infection and served to spread 
the disease. 

In the present light of the mosquito transmission of 
yellow fever, nothing can be more simple; but, when we 
come to think over the matter, we can hardly blame 
Audouard and his dintinguished champions for having 
blundered, as they were groping in the dark and launched 
the theory which seemed, under the circumstances, the 
most plausible and intelligent. 

The Gulf Stream Theory. — This doctrine cannot for 
a moment be seriously entertained and does not need to 
be dissected here to lay bare its imperfections. It ex- 
plains nothing and is dismissed without further comment. 

The Asiatic Theory. 

There is a theory, however, which takes our fancy and 
which we are prone to espouse — the opinion that yellow 
fever originated on the western shores of Asia centuries 
before the advent of Christianity. The city of Smyrna, 
in Asia Minor, is just the sort of place where a pestiferous 
disease could originate cle novo. Since the date of its 
foundation, in pre-historic times, it has been renowned 
for its filthiness and pestilences, a fame which clings to 
it to this day. 

Smyrna occupies the unique position in history of 
being the only great city of the west coast of Asia Minor 
which has survived to the present day. Unlike good wine, 
however, it does not seem to have improved with age, from 
a sanitarian point of view. It is as insalubrious to-day 
as it was in distant past, when it cradled Homer and was 
the glorious capital of Antigonus. The appearance of 
the city at the present day is very attractive when viewed 
from the harbor, but a closer inspection dispels the illu- 
sion. The houses, mostly built of wood, are mean and 
fragile looking; the streets v:lose and filthy and filled with 
intolerable stenches, proceeding from illy-constructed 
sewers and drains. Having thus all the necessary condi- 
tions present to harbor and propagate pestilence, it is 
within the reasonable bounds of probability that it could 



118 HISTORY OF YELLOW FEVER, 

have been the original nidus of yellow fever. How yellow 
fever was engendered there, what special atmosphere con- 
stitutions precipitated its origin or how it sprung spon- 
taneously into existence, our feeble powers of imagination 
cannot conjecture, but, for the purpose of propping up the 
doctrine we advance, we shall admit that it did spring 
from somewhere within the walls of the malodorous ori- 
ental town — in fact, grew, like the immortal Tops}^^ — and 
was thence disseminated by the mosquito-infected vessels 
of the Phenicians and other ancient adventurers through- 
out the then known world. 

The immigration of the Phenicians to the Mediter- 
ranean coast of Asia took place in remote antiquity. 
When the Children of Israel settled in Canaan, they found 
the Phenicians already established in the country, and 
history tells us that the tribes of Naphtali, Asher and 
Dan, to which that section of Syria was assigned, did 
not conquer Phenicia, but occu]3ied only a small portion 
of it. The Phenicians were a commercial and not a war- 
like race and their policy from the onset towards the 
Chosen People was one of conciliation and the two races 
afterwards became stalwart friends. 

From the earliest period the Phenicians occupied them- 
selves in distant voyages and their skill in shipbuilding is 
a matter of history. Lebanon supj)lied them with abun- 
dance of timber and Cyprus gave them all necessary naval 
equipments, from the keel to the topsails. In the reign 
of Pharaoh-Xecho, these daring navigators even circum- 
navigated Africa. The commerce of Tyre extended all 
over the ancient world, from India to England, and the 
maritime knowledge and experience of the Phenicians led 
to the founding of numerous colonies in Cyprus, Rhodes, 
Sicily, Sardinia and even in distant Spain, where they 
founded the famous city of Gaddier, now -known as Cadiz, 
eleven centuries before the Christian Era. 

With Smyrna as a nidus, yelloAV fever could thus easily 
have been imported to the seaports of the Mediterranean 
by the active commerce in which these remarkable people 
were engaged in. Mosquitoes .are plentiful in Western 
Asia and Southern Europe and the great plagues which 
history recounts as having almost depopulated the world 



HISTORICAL SUMMARY. 119 

at certain epochs in the distant past, were possibly yellow 
fever epidemics, spread far and wide through the medium 
of mosquito-infected ships, which sailed from infected 
points to countries free from the disease. These countries, 
in their turn, proved so many foci of infection, whence yel- 
low fever radiated to susceptible localities. In course of 
time, the disease Avas imported to A^merica by the early 
voyagers who visited this country centuries before the 
time of Columbus and gradually spread over the con- 
tinent, until it found a home suited to its permanent 
hibernation in what is now known as the yellow fever 
zone. Simple, is it not? We shall undoubtedly find scof- 
fers and unbelievers, but we advance the theory with the 
same assurance that all previous theories have been pro- 
mulgated and can safely challenge anyone to prove the 
contrary. This is the beauty of theories. You may not be 
able to prove what you say by what lawyers call '^docu- 
mentary evidence," but the burden of proving the con- 
trary is on the other fellow, and he is generally in the 
same fix when it comes to trotting out facts to prove that 
you are talking through your cliapeau. 

^'Admitting your theory to be correct," observes my 
astute friend, Mr. Doubting Thomas, ''why has yellow 
fever ceased to visit Smyrna?" 

For the same reason that it is no longer prevalent in 
Spain, Philadelphia, Boston, New York,* and scores of 
other places where it was, at some time or other, consid- 
ered endemic. 

What has brought about this change? "The disappear- 
ance of the Stegomijia Calojms from these' localities," 
would be the logical answer. But such is not the case. 
The yellow fever mosquito has been banished from New 
York, Boston, Philadelphia and other Northern places, 

* See the very interesting theory advanced by Col. W. C. 
Gorgas concerning the disappearance of the Stegomyia 
from Philadelphia, New York and other Northern locali- 
ties, published in another part of this volume, under 
the caption "The Effect that the Completion of the 
Panama Canal Will Have Upon the Probable Extension 
of Yellow Fever to Asia." 



120 HISTORY OF YELLOW FEVER. 

but, according to Theobald,^^ these insects are still to be 
found in Spain at the present day. And yet, yellow fever, 
except in a few isolated instances, has been unknown in 
that kingdom since the great epidemics which ravaged 
it in the beginning of the last century. 

Theobald does not designate Smyrna as one of the habi- 
tats of the Stegomyia Calopus, but mentions the tact that 
the insects are prevalent in Tyre, Sidon and Palestine, 
neighboring localities. ''Where the climate is not too 
dry," observes Howard,^^ '^Stegomyia Fasciata will, with 
little doubt, upon close search, be found." The climate of 
Smyrna is an ideal one for the propagation of the insect 
under discussion and it has no doubt been domiciliated 
there from time immemorial. 

But here comes the clincher : ''If Stegomyiae flourished 
in Smyrna ages past and yellow fever was an endemic, 
how is it that, with all the conditions which were then 
present existing at the present day, the disease no longer 
manifests itself?" 

The only way to get rid of this Gordian Knot is to 
treat it a-la- Alexander : 

Let us suppose that the great pestilences which devas- 
tated Europe, Asia and Africa centuries before the Chris- 
tian Era were yellow fever epidemics. History tells us 
that these outbreaks caused fearful mortalities and that 
at times "nearly half the population of the world" was 
swept away. As the years went by, new generations were 
attacked by the disease, which became milder and less 
murderous for want of fresh material, until it came to 
pass that those who remained became immune through 
acclimatization or because they had withstood a previous 
attack, and the disease gradually disappeared from its 
old-time haunts. Immigration, one of the most fertile 
feeders of endemic disease, was no longer a factor in the 
Old World after the twelfth century of the Christian Era, 
for the nomads of that period had penetrated as far as 
they dared to go, and with the whole population of the 

"=* Theobald: A Monograph of the Cu'licidae of the World, 1891. 
''"Howard: Concerning the 'Geographic Distribution of the 
Yellow Fever Mosquito, 1905. 



HISTORICAL SUMMARY. 121 

Avorld immune from ^^ellow fever, it is natural that the 
scourge should cease to manifest itself. 

It is a remarkable truth that persons born in a com- 
munity where a disease is endemic, seldom, if ever, experi- 
ence an attack. Humboldt notes the fact that a person 
born and brought up in Vera Cruz is not subject to the 
disease. The same observation has been made in regard 
to Havana. And yet, the natives of Havana are often at- 
tacked with yellow fever when they visit Vera Cruz in 
August and September; while, on the contrary, natives of 
Vera Cruz, who were known to have passed unscathed 
through violent epidemics in their natal place, have died 
of yellow fever in Havana, Jamaica and the United States. 

'^New sources of disease are developed by civilization," 
observes Gouverneur Smith,^^ ^'new measures of prophy- 
laxis germinate simultaneously with each genesis. Many 
of the poisons with which we are familiar, and which were 
known to our ancestors, are not as yet to be extinguished, 
but are to continue to harass posterity. Posterity will en- 
counter ills which have not afflicted us, and the medical 
literature of future centuries will relate the outcrops of 
novel disorders, and record the successful means by which 
they were held in abeyance. If the chemists are capable 
of producing new compounds, it can be inferred by anal- 
ogy, and even inferred from a study of past ages, that in 
the mutations of society new forms of aerial contamina- 
tions and new zymotic affections will be developed by 
reason of the overcrowdings of population, by the influ- 
ences of new occupations and of new relations of life. 
The opening of new territories to civilization will be at- 
tended with its dangers. Indigenous germs of disease may 
exist in unexplored Africa and in other secluded parts of 
the globe, which are in time to be conveyed to marts of 
commerce, and thence to be still more widely diffused." 

Gouverneur Smith's observations, made thirty years 
ago, upholds the point we wish to elucidate. 

What has kept alive the fires of pestilence in the West 
Indies? War and the Spanish soldiery. For hundreds of 
years, Spain was engaged in putting down insurrections in 

^1 Trans. N. Y. Academy of Medicine, vol. 2, 1876, p. 362. 



122 HISTORY OF YELLOW FEVER. 

Cuba, and for hundreds of years has yellow fever mowed 
down her soldiers by the thousands. 

During the period of ten years, from 1870 to 1879, 
there arrived, at the port of Havana, 151,123 Spanish sol- 
diers. During that same period, out of a total death-rate 
of 92,231 from all diseases in Havana, there were 11,837 
fatalities from yellow fever alone, of which 1,139 were 
newly-arrived soldiers, or nearly half the total mortality 
from yellow fever. 

Look over the long list of epidemics in the West Indies 
since the beginning of the last century, and you will see 
that in almost every instance the disease was either im- 
ported or attacked the newly-arrived. The natives (that 
is, descendants of the original settlers of the islands), if 
they had not been contaminated by this -susceptible ele- 
ment from a foreign clime, would never have contracted 
the disease. 

According to the views of the Havana Yellow Fever 
Commission,-^- the pure-blooded American red Indian an- 
nually proves at Vera Cruz his present susceptibility to 
yellow fever; hence there is no reason to disbelieve that 
the aborigines of San Domingo and other A,ntilles were 
susceptible, but had, in 1192, acquired immunity from the 
disease by the same process and to the same general extent 
now enjoyed by the white, black, and yellow or red natives 
of habitually infected localities in Cuba and elsewhere. 

The same reasoning holds good for Smyrna, Spain and 
other old-world localities. Natives of susceptible climes 
not having emigrated to these countries for centuries past, 
the occasional visitor of to-day is safe from attack, as the 
infected mosquitoes and their immediate posterity have 
long since ''passed in their checks'' and their descendants 
content themselves in disseminating malaria and kindred 
transmissible diseases. But let a single case of yellow 
fever be imported into the heart of Spain, Smyrna or any 
presumably former habitat of the disease, and the world 
will witness a repetition of the terrible ravages of the 
past. 

Previous to 1793 yellow fever was unknown in Dem- 

'- Annual Report National Board of Health, 1880. 



HISTORICAL SUMMARY. 12S 

erara, British Guiana, which is noted for its low, swampy 
soil, abounding in vegetable matter in a state of decom- 
position, the whole constituting a true hot-bed of pollu- 
tion, where Stegoinylae breed by millions. Yellow fever 
could not, and never would have, developed itself in that 
region; but, according to Ball}^,^^ it was introduced by 
the schooner Fanfaii in the year above mentioned, and 
finding an habitat suited for its propagation, became es- 
tablished there, and Demerara is to-day one of its focal 
points. 

Diseases, like fashions, have their whims. A locality 
may for years — aye, even centuries — be afflicted with a 
certain ailment and then, sometimes suddenly, sometimes 
with such gradual decadence as to be scarcely noticeable, 
the endemic disappears, to manifest itself in places where 
it was unknoAvn before and create the same havoc, inspire 
the same terrors and display the identical idiosj^ncrasies 
which characterized it in its old habitat. 

According to Muhry,^"^ if we except the admirable and 
accurate descriptions of diseases contained in the writings 
of the Arabian physicians, we have scarcely any of an 
earlier date than the beginning of the sixteenth century, 
sufficiently full and correct to enable us, by comparing 
the phenomena of the diseases which now prevail with 
those by which the same diseases were accompanied at 
former periods, to detect their points of resemblance or 
discrepancy^ Judging, however, from the few and imper- 
fect details furnished us by medical writings of former 
days, we believe that there are good reasons for conclud- 
ing that the more prominent diseases to which the human 
organism is now liable, are essentially the same, in all 
their leading features, with those to Avhich it was subject 
as far back as medical history leads us. 

Muhry further asks if it is true, however, that diseases 
which formerly prevailed have entirely disappeared? 
This is by no means improbable. The history of endemics 
proves very clearly that certain forms of disease depend 
upon cases of a strictly local character, and no longer 
occur when these local causes are removed. It is equally 

^* Bally: Typhus d'Amerique, p. 60. 

^* Muhry: Historical Immutability of Nature and Disease, 1844. 



1?4 HISTORY OF YELLOW FEVER. 

reasonable to suppose that morbific causes of wider extent 
may become extinct either spontaneously or through the 
agency of man, and with their extinction would, of course, 
cease the diseases produced by them. But it is not so yery 
certain, that among the diseases to which the human or- 
ganism is still subject, some at least of those which are 
presumed to haye disapeared are not to be included, but 
in a form so far modified that the resemblance between 
them and their prototypes is oyerlooked. It is, also, prob- 
able that diseases which formerly preyailed as endemics 
or epidemics, still occur sporadically; isolated cases ap- 
pearing occasionally and at long interyals, and hence at- 
tracting little attention, being yiewed as anomalous forms 
of some one of the more preyalent affections. 

Muhry-s masterly diagnosis is admirably suited to the 
subject under discussion in these pages. Take away the 
Stegomyia Calopus and you take away yellow feyer. The 
experience of New Orleans in 1905 is incontestible proof 
of the truth of this assertion. Although all the conditions 
which preyailed in 1905 existed in 1906 (with the excep- 
tion, of course, of the millions of Stegomyia), not a case 
of yelllow feyer occurred among the yast cosmopolitan 
population of the Metropolis of the South, and only a 
single case, undoubtedly imported, is known to haye oc- 
curred throughout the entire State of Louisiana. And 
this, thanks to the untiring work of the eminent sanitari- 
ans in whose hands were the destinies of the State and 
City Boards of Health, was soon rendered inocuous. 

Let us again look into the fascinating question of 
Asiatic origin of yellow feyer. 

Without desiring to be irreyerent to the shades of 
Audouard, Bally, Chisolm and others, we think that there 
is more in the theory of Asiatic origin than appears on 
the surface, when one comes to weigh it in the balance of 
conjecture. How do we know that the pestilential ardent 
feyers, or causi, of which repeated mention is made in 
the works of ancient writers, were not yellow feyer mani- 
festations? In reading descriptions or the cmisi, not only 
in the Epidemics of Hippocrates, but also in the writings 
of his contemporaries, Thucydides and Isocrates, one is 
struck by the similarity of the diagnosis g:iyen and the 



HISTORICAL SUMMARY. 125 

present accepted symptoms of yellow fever. The writings 
of Galen, Paulus Egineta, Aretus, Avicenna, Hippocrates 
( First and Third Books on Epidemics ) , Procopius ( VHis- 
toire de Son Temps), Gregorius (Histora Francorum^ de 
417 a 591 A. D.), Anglada {Etudes siw les Maladies 
Eteintes et les Maladies NouveUes) , Black {Histoire de 
la Medicine et de la Chirurgie) , and others, also lead to 
the presumption that a disease posessing all the peculiari- 
ties of yellow fever was epidemical long before the Chris- 
tian Era. 

"In the works attributed to Hipprocates," says Ban- 
croft, "mention is made of violent febrile disorders, which 
sometimes proved fatal on the fourth day, and even 
sooner,^^ and were attended with incessant vomiting, 
sometimes of black matters, yelloAvness of skin, and other 
affections so similar to those which are frequently ob- 
served in the Yellow Fever, that I am disposed to believe 
that they could be no other disease." 

Lyons,^^ commenting on the above, says : "At what his- 
toric period yelloAv fever became an established epidemic, 
it may perhaps be not possible now to determine. Some 
writers, and amongst them Bancroft, seem to think that 
certain of the fevers described by Hippocrates as being 
attended with black vomiting and yellowness of the skin, 
were of the same nature a^ the yellow fever of later times. 
I doubt much that the question admits of absolute solu- 
tion, so meagre are the accounts left us in the fragments 
of the works of the great Father of Medicine." 

Had Hippocrates any knowledge of yellow fever? At 
first thought, this looks like a startling and foolhardy 
question, but a careful perusal of the works of the Father 
of Medicine certainly leads to the conclusion that yellow 
fever, or some distemper possessing almost the identical 
symptoms of the disease, prevailed among the Greeks and 
their neighbors in the nebulous past. According to that 
learned and well-posted observer. Dr. Samuel Latham 
Mitchel, who edited the New York Medical Repository in 
the beginning of the last century, this inference is readily 

'^ This fact is rioted by Alcee Chastant, of New Orleans, in his 

Observations on Yellow Fever, published in 1878. 
^« Lyons: A Treatise on Fever, 1861, p. 249. 



126 HISTORY OF YELLOW FEVER. , 

drawn from the observations which Hippocrates makes of 
the pestilential distempers of Persia and Greece. Dr. 
Mitchell holds the opinion that it is much to be lamented 
that the Grecian sage has not left to posterity an account 
of this distemper, and of the methods he took to guard 
against it. We might, in all probability, have derived 
some information that would be of priceless value to us 
at the present time. However, although he has not left 
us the history of the disease which afflicted the Persian 
army ,and which gave so much concern to the Greeks, 
there are several passages in his works which show that 
the southern parts of Europe and the western countries 
of Asia were visited by disorders marked by yellow skin 
and black vomiting, at least four hundred years before 
the Christian era. One cannot help noticing that the 
writings of Hippocrates contain evidence enough of mor- 
bid yellowness; and that, although the different kinds are 
meant by the same word, the yellow suffusion incidental 
to fevers is clearly distinguishable from the yellow^ tinc- 
ture caused by an absorption of bile when the liver is 
obstructed. 

Black vomit is also alluded to in the works of the 
Father of Plwsics. In the tAvelfth section of his Prog- 
nostics, he affirms that if the matter vomited be of a livid 
or black color, it betokens ill. In the first section of the 
first book of his Coan Progiiostico, he enumerates black 
vomiting among a number of the most desperate symp- 
toms. In the fourth section of the same book, he considers 
leek-green, livid and black vomiting as omens of sad im- 
port. The passage in the eleventh paragraph of the first 
book of his Predictions, indicates strongly the unfavorable 
issue of a fever after black vomiting. The connection be- 
tween black vomiting and deatli is noticed likewise in the 
third paragraph of the second section of the Coan Prog- 
no stico. The same symptom is mentioned in the first 
paragraph of the first section of the same book. And the 
like will be found to recur in the fourth paragraph of the 
third section of the same book. 

From the above, it will be seen that this alarming symp- 
tom was frequent among the ancient Greeks laborincr un- 



HISTORICAL SUMMARY. 127 

der fevers, Avas well-kuown to their physicians, and was 
noticed by Hippocrates as a familiar occurrence. 

It must not be forgotten, however, that this symptom 
frequently occurs in the late stages of other dangerous 
septic conditions. 

Littre, whose famous work is one of the classics of 
medical literature, denies- that Hipi)ocrates had any 
knowledge of yellow fever and asserts that the caitsi were 
merely remittent fevers, the same as is observed in our 
days in the countries bordering on the Mediterranean. 

But Littre, in our humble opinion, is not infallible. It 
is a matter of history that yellow fever was unknown by 
that name previous to 1694, when Ferreira da Eosa pub- 
lished his admirable treatise on the pestilential diseases 
of Pernambuco. The fact that the disease Avas not men- 
tioned in ancient times by the name we now knoAV it, hoAV- 
ever, does not mean that it did not prevail throughout the 
world then or at any other time. The Avorks of noted 
chroniclers, from the time of Aretus'^^ to Guyzot,^^ abound 
Avith accounts of pestilences which ravaged Europe, Asia 
and Africa at specified epochs, depopulating cities, deci- 
mating armies and creating widespread terror and demor- 
alization. 

Even as far l3ack as 1184 B. C, during the Trojan war, 
it is said that Podalirius, a son of Esculapius, Avas iuAdted 
bA^ the Greeks to their camp "to stop a pestilence Avhich 
had baffled the skill of the physicians."^^ This disease is 
said to have resembled yelloAv fever. 

Certain authors, among them Marius de Bamberg, as- 
sert that the plague of Athens described b}^ Thucidides 
and Lucretius, was nothing less than yelloAV fcA^er. Ber- 
enger-Feraud tries to dispose of this tlieorj^ by saying that 
although the malady Avhich afflicted the ancient Greeks 
during the Peloponesean Avars Avas characterized by a 
sudden onset, great pain in the head, injection of the eyes, 
rapid respiration, etc., symptoms which may appear to 
denote yellow fever, it is also worthy of notice that 
Thucydides speaks of the red appearance of the facies of 
those affected, black and putrid ulcers, gangrene of the ex- 

" Adams' translation. 

^^See his "History of France.' 

^^ Lepriere's Classical Dictionary, p. 543. 



128 HISTORY OF YELLOW FEVER. 

tremities and the cicatrices which remained after the pa- 
tients had been cured. These latter characteristics seem 
to indicate that the Greeks were either attacked by the 
plao'ue or by malignant smallpox, or, at all events, a. 
malady totally different from yellow fever. 

Sydenham, the greatest epidemiologist of modern times, 
describes the Plague of London, in the summer and 
autumn of 1665, as havino- been ushered in by a malignant 
fever, and also alludes to a disease similar to yellow fever 
which prevailed in Moscow in 1771, where it destroyed 
80,000 persons. Aiccording to Mertins, one of the physi- 
cians appointed by the Empress of Kussia to attend the 
infected, the pestilence was introduced in Moscow by 
Turkish prisoners. 

In Hume- & Histori/ of England (page 33), occurs the 
following passage: ^'The reign of Oswy was rendered 
memorable by a most destructive pestilence called the 
Yellow Plague, which, commencing in 664, ravaged the 
whole island during twenty years, with the exception of 
the Highlands of Scotland." 

A fever similar to yellow fever has been observed in 
England and Ireland. Dr. Hamilton describes its appear- 
ance at Norfolk and Drs. Graves and Stokes*^^ speak of 
its prevalence in Dublin in 1826, though the latter ex- 
presses some doubts as to the disease being yellow fever. 
Dr. Graves, however, avers that the symptoms and ana- 
tomical characters were the same as those laid down in 
cases of yellow fever by the best authorities. 

Anstie,^^ in comparing English epidemical disease with 
yellow fever, says : ''In truth, it is difficult to read care- 
fully the histories of AVest Indian epidemics of yellow 
fever without being tempted to believe that the disease has 
strong affinities with our English typhus; and the pecu- 
liar symptoms (jaundice and black vomit) of which so 
much has been made, are in truth phenomena which are 
not infrequently witnessed in typhus and relapsing fever 

""Lectures on Fever, by Wm. Stokes (1876), p. 37. 

''^ Notes on Epidemics, by Francis Edmund Anstie (1866), p. 86. 



HISTORICAL SUMMARY. ] 29 

in Britain.^^ So often lias this been the case, that one can 
hardly avoid thinking that, were these latter fevers trans- 
ported to the peculiar tropical regions which have been 
mentioned, they would develop these features with con- 
stancy, instead of occasionally, and would then be indis- 
tinguishable from true yellow fever." 

The great American historian and philosopher. Hum- 
bolt, makes the following observations: ''It is certain 
that the vomito, which is endemic at Vera Cruz, Cartha- 
gena, and Havana, is the same disease as the yellow fever, 
which, since the year 1793, has never ceased to afflict the 
people of the United States. This identity, against which 
a very small number of physicians in Europe have started 
doubts, is generallv acknowledged by those of the Faculty 
who have visited the Island of Cuba and Vera Cruz, as 
well as the coast of the United States, and by those who 
have carefully studied the excellent nosological descrip- 
tions of M. M. Makittrick, Rush, Valentin, and Luzuriaga. 
We shall not decide whether the yellow fever is percepti- 
ble in the causus of Hippocrates, which is followed, like 
several remittent bilious fevers, by a vomiting of black 
matter ; but we think that the yellow fever has been spor- 
adical in the two continents since men born under a cold 
zone have exposed themselves in the low regions of the 
torrid zone to an air infected with miasmata. Wherever 
the exciting causes and the irritability of the organs are 
the same, the disorders which originate from a disorder in 
the vital functions ought to assume the same appear- 



CONCLUSION. 

As previously observed, we lean to the doctrine of 
Asiatic origin of yellow fever, but we are in no wise unal- 
terably wedded to the hypothesis. We have tried hard to 
be convinced, but the bewildering mass of evidence, jjro 
et con, has raised a lingering doubt in our mind, which 
no amount of reasoning has been able to eradicate. 

®- The differential diagnosis between typhus and yellow fever 
in this country is too well. established to need comment- 
ing upon. — G. A. 



ISO HISTORY OF YELLOW FEVER. 

We now bring this historical summarY to an end^ think- 
ing it unnecessary to burden these pages with further 
quotations and observatioiis. We feel we have proved 
nothing new concerning the origin of yellow fever and^ 
taking Tou into our confidence, patient reader, we must 
confess Ve never had the remotest idea of launching a new 
theory. We simply culled from the best observers and 
trust to the intelligence of the reader to make whatever 
deductions may seem proi>er or reasonable in the premises. 
So far as we are j)ersonally concerned, we beg to express- 
our opinion of the whole business by the following quota- 
tion from Peisse, taken from his great work, La Jledecine 
et Les Aledecins : 

^^Quand, par I'oljservaiion directe du regne animal^ 
etudie dans son organization intericure la plus delicate^ 
Olivier eut fini son travail, il troiiva qwil etait arrive a 
pen pres aiix menies divisions qwAristote avait etahlies^ 
il y a plus de deux mille ans:^ 

To paraphrase the above : After caref tilly sifting the 
opinions of the most noted writers on the origin of yellow 
fever, we have arrived at the same conclusions reached by 
all of them — that the disease either was endemic in 
America centuries before the arrival of Columbus, or was 
imported from some transatlantic country by the hordes 
of nondescript personages who swarmed to the Xew 
World in search of riches and adventure. But where the 
invaders primarily contracted the disease, is a question 
which reminds us of the immortal question of the small 
boy. propounded ages ago to his preceptor: 

''Which was born first, the >egg or the chicken?*' 

We find no record of the learned gentleman's explana- 
tion, and the problem will undoubtedly remain forever 
unsolved. We cheerfully relegate the yellow fever brain- 
racker to the same fate. 



PART THIRD. 



HISTORY 



OF 



YELLOW FEVER, 



BY LOCALITIES. 



YELLOW FEVER 



AS IT 



CONCERNS ASIA 



THE EFFECT THAT THE COMPLETION OF THE 

PANAMA CANAL WILL HAVE UPON THE 

PEOBABLE EXTENSION OF YELLOW 

FEVER TO ASIA. 

By Col. W. C. Gorgas. 

Assistant Surgeon-General^ U. S. Army; Chief Sanitary 

Officer^ Panama Canal Zo7ie. 

To get a basis for the discussion as to what will be the 
probable effect of commerce through the Panama Canal 
upon the introduction of yellow fever into Asia, it will be 
necessary to review roughly the past and present habitat 
of yelloAV fever, and its method of extension in the past. 

Yellow fever has only been recognized as a disease since 
the discovery of America, and its principal habitat since 
that time has been the West India Islands, and the main 
lands of both North and South America bordering the 
Gulf of Mexico and the Caribbean Sea. It has, however, 
extended at time very widely from these localities, on the 
eastern and western coast of North and South America, 
and the western coast of Africa, and the southwestern 
coast of Europe. It seems to have had its widest exten- 
sion during the latter part of the eighteenth century and 
the earlier part of the nineteenth. It has been as far 
North as Quebec in North America and as far South as 
Montevideo in South America. There have been several 
epidemics in Spain, and minor epidemics in France and 
Wales. In Europe a few cases have originated as far 
east as Genoa, Italy. It has never extended farther east 
in Europe than Genoa, nor has it at any time affected 
Asia, or the islands of the Pacific. 

With our present knowledge of its means of propaga- 
tion one can readily understand why it has not spread 
beyond these limits. The great road of travel during the 
old days of sailing ships, between Europe and America 
on the one hand, and Asia on the other, was around the 
Cape of Good Hope. This took four or five months. The 
only possibility of such a ship transmitting yellow fever 
would be that the ship itself would become infected, and 



1S6 HISTORY OF YELLOW FEVER. 

continue to have a succession of cases, and thus keep alive 
infected mosquitoes during the whole Torage. She would 
have to be breeding stegomyia mosqtiitoes aboard and 
have a case of yellow fever introduced, and infect these 
mosquitoes, and then have a succession of cases of yellow 
fever among her non-immunes that would keep up the dis- 
ease for several months. The probabilities are greatly 
against this. The probabilities are that within the first 
two months all the non-immunes aboard would contract 
the fever, and at the end of a couple of months, we would 
have a ship peopled by immunes. Every probability is 
that the infected mosquitoes left at the end of two months 
would die from natural causes within the following three 
months, and by the time the ship reached India, she would 
be entirely free from infection. Another gTcat means of 
protection was the fact that the vessel was exposed to 
freezing weather for several weeks in passing the Cape. 
Before the days of the Suez Canal there was not a great 
deal of traffic through the Mediterranean Sea to Asia, and 
what there was, was carried on by means of x)ack trains 
of various kinds. One can readily understand the im- 
probability of transmitting yellow fever in this way. I 
think our experience points to the fact that yellow fever 
is nearly always transmitted from place to place by a sick 
person going from an infected point, and infecting the 
mosquitoes in an uninfected place. It apparently takes 
pretty frequent communication to transmit the disease. 

In the earlier days of yellow fever in the United States 
it was almost entirely confined to the littoral and was 
looked upon as a disease of the sea coast. As the country 
became settled up and river traffic became great, it was 
found that it would spread up the rivers, but it was still 
looked upon as a disease confined to the sea coast and 
large rivers. When railroads were introduced, it was 
found that it spread with equal facility along railroad 
routes. 

The small amotmt of commerce and the great length 
of time that it took for a sailing vessel to cross the Pacific 
would readily account for yellow fever not having spread 
across the Pacific. With the introduction of steam ves- 
sels one would have expected that yellow fever would 



ASIA. 1S7 

have been more likely to spread to Asia, but a steam ves- 
sel breeds many less mosquitoes than a sailing vessel. The 
sailing vessel, for her long voyage, had to carry large quan- 
tities of fresh water, which were prolific breeding places 
for the stegomyia. A| steam vessel, while she can and does 
breed mosquitoes, does not do so to anywhere near the ex- 
tent that the sailing vessel does. Her expenses being 
large, she cannot afford to spend such length of time in 
port as the sailing vessel does, and is, therefore, less likely 
to become infected. And then again, the routes of com- 
merce do not extend directly from infected ports to Asia. 
It is very seldom that a vessel goes directly from Havana 
or Kio de Janeiro to Asia. The exchange is almost en- 
tirely carried on by means of London or Hamburg, or 
some other Eurojiean port. 

The effect that the Suez Canal has had as a means of the 
introduction of infectious and contagious diseases from 
Asia to Europe, would be some indication of what effect 
the Panama Canal will have upon the introduction of 
such diseases from America to Asia. The probability, 
while remote, of the introduction of yellow fever from 
America to Asia, was certainly increased by the opening 
of the Suez Canal, The city of Para, in Brazil, is the port 
in America nearest to Asia going east by the Suez Canal, 
which is at present permanently infected witli yellow 
fever. The time by steamer from Para to India has been 
reduced by the Suez Canal more than half. The whole 
route via the Suez Canal lays in tropical and subtropical 
latitudes. The likelihood of the introduction of yellow 
fever from Para to India via the Suez Canal is at present 
just about the same as it is for the transfer of the same 
disease from Guayaquil to Hong Kong. Both Guayaquil 
and Para are permanently infected with yellow fever and 
have been for years. The steaming distance from Para 
east through the Suez Canal to India is about the same as 
that west from Guayaquil over the Pacific to Hong Kong. 

While we would have to acknowledge the possibility of 
the conveyance of yellow fever to Asia by either of these 
routes, it is evidently extremely improbable. The Suez 
route has been in use for a generation, and the Pacific 
route for some three centuries, with never a single in- 



138 HISTORY OF YELLOW FEVER. 

stance of yellow fever getting to Asia. But it is probable 
that in that time there has never been a single instance 
of a vessel going directly from either Para or Guayaquil 
to Asia. As commerce goes on increasing they may, how- 
ever, occur. 

A very good example of a large commerce between ports 
infected with yellow fever, without the transmission of 
the disease, is that between the ports of Rio de Janeiro 
and Para, infected ports on the eastern coast of South 
America, and England. Also that between Guayaquil, an 
infected port on the west coast of South America and 
San Francisco. Commerce is very intimate between these 
infected ports south of the equator and the non-infected 
regions .mentioned north of the equator. Vessels sail 
between these ports oftener than weekly, and the steam- 
ing time is less than a month, yet, to my knowledge, yel- 
low fever has never been carried either to England or 
San Francisco from these sources.* But, before the open- 
ing of the Suez Canal, one, in discussing the probable 
dangers, would have thought that plague and cholera 
would be much more likely to be introduced from Asia to 
Europe than yellow fever from Europe to Asia. The com- 
merce is large and the trip not more than three weeks, 
infection from this source. Europe has, however, taken 
Yet there has been little, if any, trouble in Europe with 
the precaution to establish an International Board of 
Health which has sanitary supervision over the Canal and 
guards this route very carefully. 

I think the above fairly satisfactory reasons why yel- 
low fever in the past has not spread to Asia. It is inter- 
esting here to note the fact that the yellow fever zone had 
greatly decreased before we knew that it was transmitted 

*In one isolated instance (1883), yellow fever was imported 
into San Frapcisco, but did not spread. In 1897, 1898, 
1902 and 1903, vessels coming from South American 
ports infected with yellow fever, or on which cases had 
had developed, died or convalesced, were detained at 
the San Francisco Quarantine Station, but no new cases 
developed while the ships were in the harbor. For full 
particulars, see detailed account under "California," in 
another part of this volume. G. A. 



ASIA. 139 

bv the mosquito, and before any general measures of any 
kind vrere taken for its extinction. It extended most 
widely about the beginning of the nineteenth century. At 
this time, Philadelphia, New York, Boston, Baltimore 
and Charleston were all liable to yellow fever and had fre- 
quent epidemics. From this time it has become less and 
less frequent on the Atlantic Seaboard of the United 
States and in the United States itself. At present, I do 
not think the stegomyia is found farther north than Nor- 
folk, and she probably had the same habitat a hundred 
years ago, and it is hard to understand how New Yorl^ 
and Philadelphia could have ever had yellow fever. But 
the probable explanation is that before they had water 
supplies they used wells and cisterns generally as a means 
of storing water and thus had excellent means of breeding 
stegomyia. Sailing vessels frequently came in with num- 
bers of stegomyia aboard. When these arrived in the 
summer time, the ships continued to breed mosquitoes for 
weeks at a time while they were tied up to the wharves. 
Many of these mosquitoes wandered off to the neighboring 
houses where they found ready means of breeding, and 
thus, in a few weeks, the town became well stocked with 
stegomyia. Quarantines were very lax and a case would 
be introduced from an infected ship and find a good 
ground for spreading the disease through the city. As 
the cold weather came on all the stegomyia would be 
killed, but in some other year the same thing would occur 
over again. At present in Philadelphia thev have no 
tanks or cisterns and very few places where the stegomym 
would breed, but communication with ports where 
stegomyia breed is almost altogether through steamers 
which are not likely to bring many stegomyia, and she 
has a good quarantine which stops the large majority of 
yellow fever cases. These are the causes, I think, that 
have led to the contraction of the zone of yellow fever. 

The same statements would apply to Spain and Eng- 
land. They are not countries where the stegomyia breed, 
and these mosquitoes could only flourish there when in- 
troduced during the summer time, and when the condi- 



140 HISTORY OF YELLOW FEVER. 

tions as to water receptacles were favorable to their breed- 
ing* 

In our Southern Gulf States the stegomyia has its 
natural habitat. The weather during the winter is not 
sufficiently cold to kill off all the adults, so that we are 
still liable to an occasional epidemic when the disease is 
introduced from the neighboring West Indian ports. But 
even in these localities the winters are so cold that the 
mosquito becomes dormant and yellow fever disappears, 
even no sanitary measures are taken. As we go farther 
south and get into the tropics we find that the stegomyia 
breeds as well, as far as temperature is concerned, in one 
season as in another, and varies principally according to 
rain fall, or conditions that give more or less numerous 
breeding places. 

Now let us consider a moment the distribution of yel- 
low fever at the present time and the possibility of its 
transmission to Asia. It is at present in Cuba, Mexico, 
Central America, and on the east and west coast of South 
America. At present I do not think there is any direct 
communication between an infected port and Asia. The 
West Indies and the eastern coast of South America ex- 
change their wealth with the wealth of Asia principally 
through the European ports, and Guayaquil, which is the 
only infected port of any consequence on the west coast, 
carries on w^hatever commerce she has with Asia through 
San Francisco. 

In Southern Asia and the Philippines the stegomyia is 
a very common mosquito. The population in China and 
India is very dense and non-immune; the Chinaman and 
Coolie being just as liable to yellow fever as the European, 
and as far as we can see, it will only require the introduc- 
tion of a case of yellow fever to cause a very devastating 
epidemic, which, in the state of civilization existing in 
Asia, w^ould be entirely uncontrollable. 

If the Canal were opened to-morrow I do not think the 
chances of carrying yellow fever to Asia would be one 
whit increased over what they are to-day. At the present 

♦According to Theobald (Monograph of the Culicidae of the 
World, published in 1891), stegomyia have been found 
in Spain. G. A. 



ASIA. 141 

time such danger is very remote. It is onl}' a possibility. 
On the Pacific side ^ye have only one infected port, Guaya- 
quil. It is within the bounds of possibility for a steamer 
to sail directly from Guayaquil to an Asiatic port, be- 
come infected at the time of leaving Guayaquil, continue 
the infection by means of a succession of cases during the 
two months it would take her to reach an Asiatic port and 
implant the infection at such port. But it is extremely 
improbable. If a weekly steamer sailed from Guayaquil 
to a tropical Asiatic port the probabilities would be in- 
creased. The chances of a ship remaining infected for 
two months are small. Take, for instance, the relations 
between Cuba and Spain. For the twentj^ years before 
the American occupation of Cuba frequent steamers sailed 
from Havana to the ports of Spain. They were crowded 
with passengers, civil and military. Havana, during 
these years, always had yellow fever, summer and winter. 
Spain, as previous history has shown, was capable of be- 
coming infected. But such intimate commerce could go 
on for twenty years without establishing yelloAv fever in 
the country. SmalJh local epidemics have been established 
two or three times in Spain by this commerce since the in- 
troduction of the steamship. But it is rare. Now if the 
time of transit were made eight weeks, instead of two, the 
probabilities of carrying the disease Avould be greatly de- 
creased. I think that if such had been the case, Europe 
would have remained as free from yellow fever as has 
Asia. 

The Commission which was appointed by the United 
States to examine and report upon routes across the 
Isthmus, and which finally recommendied the Panama 
route, discussed at considerable length as to what would 
be the probable amount of commerce through the Canal 
and as to where it would come from. They quote the 
commerce of the great canals of the world at present in 
operation and its rate of increase yearl}^ from the open- 
ing of these canals. From this data they conclude that 
ten millions tons per year, will be a large tonage for the 
first ten years. 

Assuming that commerce Avill always follow the short- 
est and quickest routes between two points, they show 



142 HISTORY OF YELLOW FEVER. 

that almost all European ports are nearer Asiatic ports 
via the Suez Canal than via the Panama Canal, and that, 
therefore, Panama will get very little trade from Europe. 
They conclude that the traffic through the Suez Canal 
will not be interfered with by the Panama Canal; that 
this traffic will come principally from the United States; 
some from the West Indies and South America and a very 
little from England. Accepting this as a basis for discus- 
sion, we see, that, if yellow fever . infection is distributed, 
at the time of the opening of the Canal, as it is at present, 
ships passing through the Canal and going to Asia from 
Vera Cruz, Havana and Kio de Janeiro, would be the 
only ones which could possibly carry infection. A half 
a dozen ships a year would be a large average for these 
ports. The other ports at present infected will probably 
never send a ship through the Canal to Asia. 

How will the opening of the Panama Canal affect the 
^chances of this introduction? It will, no doubt, increase 
somewhat the commerce between infected ports and Asia, 
and vastly increase the commerce between North America 
and Europe, on the one hand, with Asia on the other. 
Ships in passing through the Canal will touch at Panama 
and Colon and be some twelve or fifteen hours crossing 
the Isthmus. If this territory is infected with yellow 
fever at this time it will greatly increase the chances of 
some of these numerous vessels becoming infected, and 
therefore, the possibility of yellow fever spreading to Asia. 
If we could bring about such conditions, therefore, that 
no vessel in passing through the Isthmus would be liable 
to become infected with yellow fever, and so that no ves- 
sel from an infected port would be allowed to go through 
the Canal, with any possibility of her carrying infection, 
Asia would be no more liable to get yellow fever from us 
than she is at present. 

To bring this happy condition about, we would have to 
keep the Isthmus itself free from yellow fever, and to 
guarantee, by means of rigid quarantines, that no infect- 
ed vessel passed through the Canal. Both these things 
are possible of accomplishment. Modern sanitary meas- 
ures have demonstrated the fact that even in the tropics 
it i;: possible to rid a locality of yellow fever and keep it 



ASIA. 143 

free. This has already been done at Panama. It has been 
over a year since a ease of yellow fever has occurred in 
the city of Panama, and only one case has occurred on 
the Isthmus in the year 1906. There is a much larger non- 
immune population on the Isthmus at present that was 
ever here before, and that iDrobably ever will be here after 
the construction of the Canal. 

The same system of quarantine that has kept yellow 
fever for the past three years from being introduced by 
shipping from the neighboring infected ports, into the 
Zone, will also in the future prevent an infected ship 
from passing through the Canal. 

Whether the Panama Canal, when completed, will be 
a menace to the health of Asia all depends upon the effi- 
ciency of the government which controls the Zone through 
which it passes. If the Zone remains an endemic focus, 
as in years past, the probabilities of transmittino- yellow 
fever to Asia, by the largely increased direct traffic, will 
be augmented. If the Zone is kept free from yellow fever, 
and the last three years of sanitary work by the United 
States Government at Panama has shown that this is 
entirely possible, then the liability of the introduction of 
yellow fever into A-sia will not be at all increased by the 
opening of the Canal. 



SYRIA. 

Geographical and Historical. 

Syria forms part of Asiatic Turkey, south and south- 
east of Arabia and borders on the Mediterranean. It has 
a population of about 1,500,000, and area of about 70,000 
square miles. In ancient times, Syria formed a part of 
the Byzantine Empire, and was successively conquered by 
the Persians, the Greeks and the Komans. Since then, 
its political history has been varied and sensational. It 
was taken by the Arabs in 636 A. D., by the Sedjuk Turks 
in 1078, by the Crusaders, by the Mamelukes and by the 
Ottoman Turks, AA^ho added it to their empire in 1517. In 
1833, it was conquered by Mehemet Ali and annexed to 
Egypt, but was restored to Turkey in 1840 by the interven- 
tion of the great powers of Euroj)e. Bethlehem, the birth- 
place of our Savior, is located in Syria. 

Alleged Outhrealv of Yellow Fever in 1800. 

Yellow fever has never invaded Asia, so far as history 
informs us. The probability of the disease being carried 
to the Ancient Continent is ably and comprehensively dis- 
cussed by Col. Gorgas in the preceding Chapter. We do 
not believe that the incident related below was an out- 
break of yellow fever, but give it a place in this volume to 
complete our records of reported eruptions of the disease. 

According to Dr. Larrey, Avho was Surgeon-in-Chief in 
the Army of Napoleon during the campaigns in Egypt and 
Syria, yellow fever prevailed in Western Asia among the 
troops under General Kochler, in the summer and autumn 
of 1800. Dr. Larrey gathered his facts from the medical 
journal of Dr. Witman, a physician who was with the 
English military commission. We cull the following from 
Dr. Larrey's observations:^ 

Dr. Witman relates that, in the autumn of 1800, while 

^Memoirs of Military Surgery and Campaigns of the French 
Armies, etc., by D. J. Larrey (Hall's Translation), 1814, 
p. 234. 



SYRIA 145 

the military commission remained on the coast of Jaffa — 
a maritime town of Palestine, 31 miles northwest of Jeru- 
salem — where it was encamped with the army of the 
Grand Vizier, a malignant bilious remittent fever made 
its appearance. It commenced about the middle of Au- 
gust, and continued with much severity through the 
months of SeiJtember and October, lasting until Decem- 
ber. The weather was foggy, and very warm, the tempera- 
ture ranging from 90° to 98°. The nights, however, were 
cool and moist. The first victims of this disease were two 
of the artificers attached to the English forces ; the malady 
soon extended to the camp of the Turks, w^here it caused 
great mortality. 

The symptoms that appeared in this disease, according 
to Dr. Witman, were at first chilliness, pains in the head 
and prostration of strength ; after these a burning pain of 
the stomach and abdomen, nausea, a bitter taste in the 
mouth, and copious vomiting of bloody and bilious matter, 
with a diarrhea, of the same appearance; the tongue of a 
yellowish black, an ardent thirst, the pulse quick and 
strong, the skin yellow and hot, the respiration hurried. 
When the fever assumed an unfavorable character, it was 
attended by delirium ; the eyes were inflamed, and the skin 
often affected with dark colored spots. This disease ad- 
vanced with more or less rapidity, according to the state 
of the mind and body, age, and particular regiment; also 
with many circumstances connected with the place and 
the atmosphere. 

The wife of General Kochler, commandant of the Eng- 
lish forces, was the first to be stricken with the disease 
after the artificers had been attacked, and died on the 
seventh day. The general, wiio had faithfully nursed his 
consort during her illness, also contracted the disease. He 
died on the third day after being taken ill. 

The disease caused much mortality among the soldiers. 
In the months of November and December it subsided 
and was replaced by the plague, which was brought into 
Egypt by the invading armies and raged with unusual 
violence in that already much afflicted country. 

It is to be regretted that Dr. Larrey could not collect 



146 HISTORY OF YELLOW FEVER. 

more circumstantial details relatire to tliis outbreak, es- 
pecially as regrards tlie pathology of the disease. The 
results of the dissections which were undoubtedly made by 
Dr. Witman and his fellow j)hysicians would have proved 
a Valuable addition to the history of this epidemic. 



HISTORY 

OF 

YELLOW FEVER 

IN 

AFRICA. 



ANGOLA. 

.Description. 

Angola is a Portugese colony on the '»7est coast of Africa, 
south of the Congo Free State. It consists of four dis- 
tricts — Congo, Loanda, Benguela and Mossamedos. An- 
gola was for a long time the radiating point of the slave- 
trade. Capital, St. Paul de Loanda. 

YELLOW FEVER YEAES. 

1860; 1862; 1863; 1865. 

SUMMAEY OF EPIDEMICS. 

ISoO. 

Although the coast of Angola was discoyerei by the 
Portugese in 1186 and colonized soon after, we find no 
mention of yellow fever having prevailed in that locality 
previous to 1860. As Angola was the most active centre 
of the slave-trade in the past, there is no doubt thiit the dis- 
ease was imported and flourished there often^ although 
official confirmation is lacking on this score But we 
come across the same hiatus almost everywhere iu Africa. 
All the colonies along the Atlantic seaboard are controlled 
by European governments, whose policy of concealment 
and suppression has been instrumental in closing every 
avenue of research in that direction, so as to throw dust 
in the eyes of their own people and put down the bars to 
immigration. 

The outbreak of 1860, according to Berenger-Feraud* 
(page 136) was quite severe; but, beyond the mere men- 
tion of this fact, the noted epidemiologist is as silent as 
the proverbial bivalve. 

*Berenger-Feraud: Traite Theoriquo et Clinique de la Fievre 
Jaune, Paris, 1891. 



ANGOLA. 151 

1862. 

St. Paul de Loanda was again visited by yellow fever 
in 1862 (Berenger-Feraud, page 139). No details are ob- 
tainable. 

18G3. 

The epidemic which had its inception in 1862^ continued 
in 1863 (Berenger-Feraud, page 140). It was brought 
that year from Angola to Grand Bassam (q. v.). 

1865. 

The year 1865 furnishes the last record of yellow fever 
in Angola. According to Mackay (cited by Berenger- 
Feraud, page 141), it was quite severe at St Paul de 
Loanda. 



ASCENSION ISLAND. 

Description. 

The Island of Ascension is a mere speck near the middle 
of the South Atlantic Ocean, about 750 miles northwest 
of the historic Island of St. Helena, and belongs to Great 
Britain. It is only 36 miles in circumference, 8 miles at 
its widest part, is of volcanic origin, and is chiefly cele- 
brated for its turtle, which are the finest in the world. 
The capital, George Town, located on the west side, has a 
population of about 150, and is gorerned under the admir- 
alty by a nayal officer. The total population of the colony 
is about 400. 

YELLOW FEVER YEARS. 

1818; 1823; 1838; 1817; 1859; 1873. 

SUMMARY OF EPIDEMICS. 

1818. 

According to the Second Report on Quarantine?- page 
197, a feyer called ''bilious remittent,'' .but which was, no 
doubt, yellow feyer, prevailed on the Island of Ascension 
in 1818. The fever attacked "every man on the island," but 
the mortality was small. In the journal kept by Mr. 
Robert Malcolm, who was stationed at George Town in 
1818, appears the history of a case of the disease, which 
commenced on the first day of June and was terminated 
by death the next day, ''with all the symjjtoms of yellow 
ruffusion and black vomit." 

The fever was, no doubt, imported from America by 

^ Second Report on Quarantine : Yellow Fever, with Appen- 
dixes, by the General Board of Health; Presented to 
Both Houses of Parliament by Command of Her Majesty. 
London, 1852. The First Report is a general treatise on 
epidemic disease's; the Second Report deals principally 
with yellow fever. 



ASCENSION ISLAND. 153 

some of the many trading ships which stopped at Ascen- 
sion on their Avay to African ports, but the framers of tlie 
**Second Eeport" vehemently deny this, claiming that the 
fever was en_gendered ''by an unusually wet turtle season, 
when the men are much exposed by watching at night to 
turn these animals." 

This explanation seems amusing and absurd when 
viewed in the light of our present knowledge of the trans- 
mission of yellow fever, but the statement was undoubted- 
ly accepted as gospel truth by the learned men of the 
period. It must also be remembered that the ''Second Re- 
port" was written under direction of the British Govern- 
ment, and as England's merchant marine dotted the seas 
at that time, the interests of her vast commerce demanded 
that the theory of importation be tabooed and ridiculed, 
even at the sacrifice of truth. According to an old saying 
of the ante-bellum Louisiana negro, Ravet pa gaignin 
raison divan poiile^ and the astute and narrow-minded 
compilers of this "Report" resort to all sorts of ingenious 
metaphors in their attempt to refute every proved instance 
of importation of yellow fever, twisting facts with amaz- 
ing cold-bloodedness and striving with every fiber of their 
prejudiced minds to prove that everybody but themselves 
are falsifiers. 

We regret not being able to gi\e a detailed account of 
this outbreak, the first on record in the eijidemiological 
history of Ascension. Even our old reliable friend, Ber- 
enger-Feraud, disposes of the subject with barely two lines, 
referring the reader to the unsatisfactory account con- 
tained in the "Second Report on Quarantine," v/hich, as 
we have seen, is historically incompu te. 

1823. 

An Heirloom in the Annals of Medicine. — The Case of the 
' ''BannJ' 

In 1823, the diminutive islet of Ascension^ which looks 
like a pin-head in the vast wastes of wf^ters which surround 

^ The roach, has no voice in an argument with chickens. 



154 HlSTOaY OF YELL W FKWa.. 

ir, assumed the magnitude of a eont-nent in the imag^na- 
lion of the hoarr-headed chroniclers who catered to public 
opinion in the beginning of the last century- This anomal- 
ous state of things was brought about by an occurrence 
which led the medical men of the period into a renewal of 
the acrimonious and endless controTersies conc-erning the 
c-ontagiousness or non-contagiousness of yellow fever — a 
war of words which had been waged witL more or less 
fierceness since 1793, and which furnished material for dis- 
cussion in the lay and medical jiress for fifty years after- 
wards. This noteworthy event was the arrival, on April 
25, 1823, of the British ioop Bann in the harbor of George 
Town, the lava-fringed capital of the Islai^d. 

The case of the Bann is an heirloom in the annals of 
ej>ideniiology. To jjublish all that has been said, dis- 
cussed and written about this '^celebrated case,-' would 
take, at least, half a dozen volumes of several hundred 
pages each ; so we will merely confine ourselves to a recital 
of the incidents which led to the infection of the Island of 
Ascension, as abstracted from the report of Sir Wdliani 
Burnett, in his comx^rehensive work published in 1819.^ 

Owing to the universal interest which was evinced in 
the case of the Bann during the last century, we have seen 
fit to go into details which will doubtless seem unimpor- 
tant — and, mayhap, tiresome — ^to the * lay reader, but 
which are absolutely essential to a faithful narration of 
the historic event. 

The British sloop Bann anchored in the Sierra Leone 
river, Wei^t Africa, on the 11th of Jsnuary, 1823, after 
having cruised in the Bight of Benin. She remained at 
Sierra Leone until the 25th of March, part of her crew be- 
ing employed in her tender, the 8an Raplmel. The men 
were greatly exjxised in refitting the rigging of both ves- 
sels, and the schooner having been sent up the river to 
Bounce Island to have her bottom rexmred, she was there 
laid on the beach, and the men exposed on shore in one of 
the most unhealthy spots in the colony. 

On the 1st of March, 3Ir. Higgon was seized with fever 
Trhile on the San EaphaeL- where he had been for some 

'Burnett: A Report upon the Diseases of the African Coast, 
1849. 



ASCENSION ISLAND. 155 

days Avitli a party of men actiyely employed getting her 
ready for sea. On the morning of tlie second lie was better, 
but became worse in the eyening. He had mo^'e feyer, 
which increased until the 3rd, when in the eyening he re- 
mitted. On the 4th and 5th it appears to liaye been moder- 
ate, and on the 6th he Ayas free from all complaint but de- 
bility. His. eyes were slightly yellow. 

On the 10th of March four cases occurred in the same 
yessel, the San Raphael, while at sea. In only one of the 
cases, which is detailed at length, there were slight remis- 
r^ions, as in the preceding. On the 15th the skin assumed 
a yellow tinge, but the patient recoyered: and was dis- 
charged to duty on the 24th. On the 25th another man 
was attacked in the tender, which had returned to the 
anchorage of Freetown. He had been only three days on 
board. On the 26th there was a slight remission, followed 
by an accession of feyer. On the 27th there was a second 
remission, followed by an accession. On the 29th he be- 
gan to sink, and died early on the 30th. The integuments, 
which Ayere slightly yellow, assumed a yery deep color after 
death. This Ayas the first fatal case that occurred amongst 
the crcAy of the Bann. Three men, tAyo on the San Raphael 
and one on the Bann, Ayere attacked on the 26th, but they 
all recoA^ered. 

The Bann sailed on the 27th of March, but remained 
about the mouth of the riyer until the 29th. Three cases 
occurred on the 27th, but they AA^ere all of an ephemeral 
nature, the Ayliole of the men haying retarned to duty 
AAithin a Ayeek. On the 31st there was a case of more 
seA-erity, the patient haying been on the sick list for nine- 
teen days. On the 3rd of April, there were four attacks. 
These, AAdtli one exception, Ayere all slight cases. On the 
7th of April, elcA^en days after the Bann left Sierra Leone, 
there AA'as a scA^ere case, which terminated fatally on the 
12th. From this time the disease assumed a greater de- 
gree of malignity and the deaths became more frequent. 
Only one of the cases Ayhich occurred about this period 
is detailed in the surgeon's journal. The patient Ayas at- 
tacked on the 14th, but had felt unwell for a fcAy days 
preyiously. He had the usual symptoms of fe^er, which 



156 HISTORY OF YELLOW FEVER. 

were relieved by bleeding. Early on the 15tli, lie suffered 
less from pain, the skin was hot, but moist and the pulse 
was full and quick. At 9 a. m. he was again bled, which 
seemed to relieve him, but at noon the bad symptoms re- 
turned. The skin became very hot the pulse 120 and 
strong. There was, in fact, an accession of fever. On the 
evening of the 16th slight stupor supervened^ and the fever 
continued to be high. On the ITtli the symptoms were 
more favorable and there was a decrease of pyrexia, but 
on the 18th, about noon, the patient became suddenly 
worse and died almost immediately afterwards. Neither 
black vomit nor yellowness of skin is mentioned. 

It was intended to proceed with the vessel to the Island 
of St. Thomas, in the Bight of Biafra, but on account of 
the rapid increase of the fever and the bad state of the 
weather, a run was made for the Island of Ascension, 
which was reached on the 25tli of April, the Bann having 
lost thirteen men by fever up to that per'od. The viru- 
lence of the fever was most marked about the third week 
in April, a few days after the vessel crossed the equator, 
and when within a few hundred miles of Ascension. On 
April 22d eight men were attacked, not one of whom sur- 
vived ; three died on the 26th, two on the 27th, tAvo on the 
29th and one on the third of May. The total number of 
cases on board the Bann was 99 and the mortality 34. 

The fever was carried by the offtcers and crew of the 
Bann to the detachments of Royal Marines stationed at 
George Town, the capital of Ascension, and spread 
throughout the island. There were altogether 28 cases 
and 15 deaths, a mortalitj^ of over fifty per cent. 

The theory of importation in the above instance is 
viciously assailed by the ''Second Report on Quarantine," 
pages 89 and 196, but the arguments advanced are de- 
cidedly vapid and irreconciliable with strict veracity and 
common sense. , 

1838. • ^ 

The Case of the ''Etna J' 

From 1823 to 1838, the Island of Ascension Avas free 
from yellow fever. In 1837. there was a severe epidemic 



ASCENSION ISLAND. IS7 

in Sierra Leone and the infection was finally brouo:ht to 
the island in 1838 by one of the many English war vessels 
which were constantly cruising about the South Atlantic - 
waters, ready to pounce upon the enemy and annex every- 
thing reachable. The source of infection was finally 
traced to three vessels, but which one of the three was the 
active cause of the epidemic is a mooted question to this 
day. 

The facts, according to the literature of the period, are 
as follows :^ 

The ship Etna arrived from Gibraltar in the roads off 
Sierra Leone in November, 1837. The fever at the time 
was committing great ravages among the prize crews and 
merchant seamen. On the 3rd of December, the Etna^ 
having Avatered, and taken on board some African boys 
and^Kroomen, sailed from Sierra Leone. On the 8th, one 
of the African boys was taken ill with a slight feverish 
attack, which did not attract any attentioii. On the 10th 
(December) two serious cases of yellow fever occurred in 
two Europeans^ who had been on shore and much exposed. 
On the 12th two more cases occurred, and of these four 
cases, three died of black vomit On the 20th two other 
cases occurred and five on the 21st. The disease then at- 
tacked officers and men indiscriminately. On the 20th of 
January, when the vessel anchored at Ascension, 99 cases 
had occurred and 25 deaths. Only five of the ship's crew 
entirely escaped. 

Shortly after the departure of the Etna, the Forester 
left Sierra Leone for Ascension, with the fever raging on 
board. On the way to Ascension, she fell in with the 
Boiietta, bound also for Ascension, and sent on board a 
prize crew. Immediately after this, yellow fever appeared 
on board the Bonetta and was extremely fatal. Both ves- 
sels arrived at Ascension simultaneously and shortly after- 
wards yellow fever appeared among the residents of the 
Island. Now, whether the infection was brought by the 
Etna, the Bonetta, or the Forester, or by all three vessels, 
which arrived at Ascension about the same time, is a 
problem which nearly made driveling idiots of the honor- 

* British and Foreign Medico-Chirurgical Review, 1849, vol. 4, 
p. 467. 



158 HISTORY OF YELLOW FEVER. 

able medical men who fought orer the momeutous ques- 
tion, and which the writer is too modest to presume to un- 
ravel. 

The evidence further goes to show that the Water wit ch^ 
arriving at Ascension from a healthy port, with a healthy 
crew, contracted yellow fever at Ascension and carried it 
to sea- losing 15 men out of 60 within a period of 40 days. 
But, to the credit of the astute disputants of the period, 
the Waterwitch was never accused of having brought the 
pest to Ascension. 

1847. 
Importation hi/ the ^^ Eclair/' 

Eight years elapsed Avithout a single case of yellow 
fever being noticed at Ascension, but an epidemic was nar- 
rowly averted in the beginning of 1847, when tv>'o cases 
developed on board the British ship Rosamond, formerly 
the Eclair, which vessel had played such a sensational role 
in the transmission of yellow fever to Boa Vista, Cape 
Verd Islands, in 1845, and to Woolwich, England, the 
following year (1846). The history of the inception and 
progTess of the disease on board the Eclair is interesting. 
To avoid repetition, we refer the reader to the compre- 
hensive account given elsewhere in this volume of the 
memorable epidemic which devastated Boa Vista in 1845.''^ 
The facts of the outbreak of 1847 are as follows : 
From the account given by the Second Report on Quar- 
antine, page 98, the Eclair was completely overhauled and 
fitted out anew at Woolwich, where she was commissioned 
for the Cape of Good Hope on Xovember 5, 1846, under 
the new name of Rosamond, as the old name was looked 
upon as a ''hoodoo." It is of record that during the time 
of fitting out, four cases of typhus fever occurred on the 
ship and were sent to the hospital, where two of them died ; 
but it is also known that typhus prevailed at Woolwich 
at that time. The steamer left England for the Cape on 
February 23, 1847. Three days aft^r sailing, one of the 
men was affected with slight febrile symptoms and he con- 
tinued more or less indisposed for a number of days, but 
'See "Cape Verd Islands." 



ASCENSION ISLAND. 159 

occasionally felt so well that lie returned to his work. 
After the ship entered the tropics, however, the disease 
began to assume a new and alarming character; and when 
off the Island of St. Nicholas, and almost in sight of Boa 
Vista, the man died, having had for two days previous 
black vomit and other characteristic symptoms of yellow 
fever. Within a few days afterwards, the Rosamond ar- 
rived at Ascension, where two other cases developed. The 
infection did not spread to the inhabitants of the Island, 
and no mention is made in the Report of any additional 
cases on board the ship, so we take it for granted that there 
were none. 

The great point of interest, however, is the persistence 
with which the spectre of yellow fever hovered over the 
Eclair, and the only explanation which we can make at 
this latter day^ is that infected mosquitoes were impris- 
oned in the hold of the vessel and were the active agents in 
the distribution of the poison which caused the sporadic 
outbreaks which followed in the wake of the vessel. 

1859. 

Yellow fever was carried to Ascension by the British 
war vessels Trident and Sharpshooter, in 1859, under the 
following circumstances :^ 

Yellow fever was quite severe at Sierra Leone in 1859. 
In the middle of May, the war-vessel Trident was infected 
at Freetown. The disease spread rapidly to the officers 
and men and the ship was put to sea, with a view of ar- 
resting the progress of the malady, but without the wished- 
for result. She returned to Sierra Leone on June 10 and 
sailed for Ascension on June 17, where she arrived on 
June 27, having lost 17 men since the eruption of the 
fever. Fifty-two cases were then on the sick list, 31 of 
which were sent on shore to the garrison hospital, and the 
remainder to the convalescent hosijital on the Green Moun- 
tain. The remaining part of the crew way landed and 
placed under canvass in a small bay about two miles from 
the garrison, with which all communication was inter- 

« statistical Report of the Health of the Navy of Great Britain 
for 1859 (London, 1862), p. 83. 



160 HISTORY OF ^-ELLOW FiTVER. 

dieted. The disease continued to txtend among t3ie ^rew 
on sliore until tlie middle of JnlT, wMen it entirely ceased. 
Of 143 of all ranks and ratings on board, namely, 110 
Enropeans and 33 Africans, 101* were attacked and 44 
died. 

Eleven cas€^^ of yellow fexer occurred on tlie Sharp- 
shooter, which lay off Sierra Leone from the 9t3i to tMe 
16t!i of December- Disease is said to haTe originated thus : 
On December 12 the Sharp sliooter was taken a]ongside a 
schooner for a supply of coal ; in this xessel the body of a 
seaman, who had died on the Surprise of yellow fever, was 
deposited previous to interment ; and though the fever was 
sujjposed to have ceased in the town it was still prevalent 
in merchant vessels. The Sharpshooter s men, who were 
employed in the coal vessel, compLiined of the effluvium 
of bilge water, and said it gave them headache. On De- 
ceml>er 21 the Sharpshooter sailed, and on that day a boy 
who had l>een c^cmplaining the day before of severe head- 
ache was attacked; the fever ran a rapid course, and he 
died on the morning of the 22nd. Other cases followed 
rapidly. The ship then stood out to sea for a few days 
and kept about 90 miles from land. This seemed to check 
the progTess of the fever. On Dec*eml>er 27 sct ,eral new 
cases occurred and the ship sailed for the Island of Ascen- 
sion. In neither of the abore instances was the disease 
communicated to the inhabitants of Asc^Bsion. 

1873. 

The Case of the ^'Amethyst.-'' 

For fourteen years, Asc*ension had a respite from yellow 
fever, and would have enjoyed immunity to this day, had 
not imjiortation again threatened tc kindle anew the dor- 
mant fires of pestilence. It does not appear that any cases 
of yellow fever were observed among the British war ves- 
sels or the land forces in the vicinity of the Island, yet the 
ship Amethi/st is accused of having brought the fever to 
Ascension from Cfij^e Coast, Africa. 



ASCENSION ISLAND. 161 

This war steamer, according to Smart,'^ was despatched 
from the coast with a large number of invalids, many of 
whom were from Elmina. After five days at sea, she 
reached Ascension on the 20th of December, and landed 
her invalids. Among these there was a case of continued 
fever with great nervous tremor^ who died on the seventh 
day after landing. Another case was moribund when sent 
ashore, djing in thirty-six hours. The symptoms were 
great anxiety, intense headache vvdth deafness, epigastric 
pains, dry red cylindrical tongue rapid pulse and respira- 
tion, injected eyes, a yellow surface, ecchymosed as death 
approached, relaxed bowels, vomiting of dark tar-like 
fluid, and suppression of urine — symptoms closely allied 
to those of yellow fever. 

On the third day after being landed, one of the. invalids, 
after a few hours of slight discomfort, fell down almost 
lifeless, and vomited and purged at the same moment a 
dark tar-like fluid mixed Avith pure blood; the features 
were deathlike, the surface cold and of a dirty yellow color, 
pulse scarcely perceptible, respiration slow and sighing. 
Under treatment by stimulants, with opiates, he rallied, 
vomiting ceasing after a few hours, when a typhous 
state supervened, lasting to the end of the second day, after 
which he convalesced. 

Another case was similarly attacked on the fourth day 
after landing, went through an analogous course of symp- 
toms, convalescing from the end of the following day. 

The train of symptoms and events in the above cases, 
according to Dr. Smart, were sufftciently diagnostic of 
severe bilious remittent fever of the English nosology, and 
of the gastroenteric type of algide pernicious fever of the 
French nosology; from which the Doctor infers that the 
disease carried from Cape Coast to Ascension in the 
Amethyst w^as of the remittent, and not of the yellow fever 
type. Be that as it may, we think the cases sufficiently 
diagnostic of yellow fever to class them as such and place 
this outbreak among our records, 

^ Smart: Transactions Epidemiological Societv of London, 
vol. 3, p. 508. 



BANANA ISLANDS. 

Description. 

The Banana Islands are a group of small islands off the 
coast of Sierra Leone, Africa. Tlney are seldom visited by 
white men, which no doubt accounts for the fact that only 
a single outbreak of yellow fever is recorded as having 
taken place there. 

YELLOW FEVER YEAR, 

1847. 

SUMMARY OF EPIDEMIC. 

Our authority^ does not give the source of infection, but 
relates the following facts : On the 26th of July, 1847, the 
British brig Syren detached a party of three officers and 
twenty- seven men to the Banana Islaods, for the purpose 
of blockading the Sherbo River. On August 14, a case 
of fever occurred, and, subsequently, scattered cases ap- 
peared till September 20th, when the blockade was aban- 
doned. The first cases were said to be of a purely endemi- 
cal character. The disease then assumed a worse form, 
until it merged into yellow fever, with its characteristic 
symptom, black vomit. 

The number of cases and deaths is not aiven.^ 



^Bryson: British and Foreign Medico-Chirurgical Review, 

1849, vol. 4, p. 470,. 
^ This is unfortunately the case in about every account of 

yellow fever in Africa. 



BENIN. 

Description. 

Benin is a negro kingdom of West Africa, in Upper 
Guinea, on the Bight of Benin, extending along the coast 
on both sides of the Benin River, west of the Lower Niger, 
and some distance inland. It has no political unity and 
has no commercial importance. Benin, the principal town, 
has a population of about 15,000. In the days gone by, it 
was the great slave emporium of the district. The religion 
is fetichism. Human sacrifices are numerous and cruelty, 
in its most atrocious forms, is characteristic of the people. 

YELLOW FEVER YEARS. 

1520; 1553; 1558; 1588; 1828; 1852; 1853; 1854; 1855; 
1856; 1857; 1862; 1873. 

SUMMARY OF EPIDEMICS. 

1520. 

Berenger-Feraud,^^ quoting Valkanaer,^^ gives an ac- 
count of an epidemic, said to be yellow fever, which at- 
tacked the crews of the Portugese explorers in the Gulf of 
Benin in 1520. No information as to the origin of the dis- 
ease is given. 

1553. 

In August, 1553, an Englishman named Windham and 
a Portugese, Antoine Pinteado^ sailed from Plymouth, 
England, for the West Coast of Africa, to explore and 
colonize the country. The expedite' on consisted of two 
ships, manned by a crew of 140 men. Shortly after reach- 
ing: the Gulf of Benin, thewressels were attacked by a malig- 
nant fever, which proved so fatal that it was found neces- 

^^ Berenger-Feraud : Traite Theorique et Pratique de la Fievre 

Jaune (Paris, 1890), p. 27. 
"Vol. 1, p. 370. 



164 HISTORY OF YELLOW FEVER. 

sarv to burn tlie ships, there not being enough men left 
to inan them. Only 39 of these adventurers returned to 
Plymouth, making a death-rate uf TO per cent. This 
''malignant fever" is said to have been yellow fever, but 
how, where and by what means the infection was contract- 
ed, our source of information^- does not say. As Wind- 
ham's vessels originally sailed from a port where fever has 
never prevailed de novo, commtmication was evidently had 
with some of the slave-shii^s which then did quite an ex- 
tensive business between Africa and Cuba^ Mexico and 
South America — for even at that early period the Span- 
iards stole negroes by the thousands to work their j)lanta- 
tions in the New World — and the sturdy sons of a north- 
ern clime proved easily stisceptible to the bites of the 
stegomvia. 

155S. 

In 1558. an explorer named Torwson and his compani- 
ons were stricken with yellow fever while in the Gulf of 
Benin.^^ The data as to this outbreak are very meagre. 

15S8. 

Bird and XewtoUj^^ intrepid voyagers in search of ad- 
venture and wealth, and their comi^anions are said to have 
experienced vellow fever while in the Gulf of Benin in 
1588. 

1828. 

From 1588 to 1828, a i)eriod of two htmdred and forty 
years, there is no record of any yellow fever outbreak in 
the Gtilf of Benin. This seems almost incredible, btit even 
such a careful observer as Berenger-Feratid has failed to 
find any data for these '^silent years.*' In 1828, however, 
the disease broke out afresh,^-^ being imported from Sierra 
Leone by the ship La BordeJaise^ and ravaged all the coast 
*owns from the Gulf of Benin to Gambia. 

^' Gazette des Hopitaux, Paris, vol. 57, p. 661. 
^^ Berenger-Feraud, loc. cit, p. 27. 
^'* Berenger-Feraud, loc. cit. p. 27. 
^ Berenger-Feraud, loc. cit., p. 105. 



BENIN. 165 

1852 to 1857. 

After an interyal of twenty-four years, yellow fever 
was again imported to the Gulf of Benin in 1852 and cases 
occurred sporadically every year from that date until 1857. 
Our authoritv^^ does not sive anv details. 



&^ 



1862. 

In 1862, yellow fever was imported to Benin and other 
countries on the West Coast of Africa (presumably from 
Havana or South America) by some of the nondescript 
craft engaged in the slave-trade between Africa and the 
Spanish-American countries. Early in ^lay, the fever 
broke out among the natives huddled in the towns and 
hamlets located along the banks of the Bonny Tiiver, and 
-spread rapidly to the officers and white porticrs of the 
crews of the palm-oil vessels in the river. The contagion 
then successively attacked the crews of vessels lying at 
anchor in the numerous rivers flowing into the Gulf of 
Biaffra,^^ more especially the Old and New Calabar and 
Brass rivers. It was particularly fatal at Bonny, then a 
notorious slave-mart, where it mowed down natives and 
Europeans alike. The epidemic, although of a vicious 
and generally fatal type, was of short duration, disappear- 
ing from all the rivers and bordering villages by the end 
of June. 

The source of this epidemic has never been clearly estab- 
lished. That section of Africa was then one of the most 
active centres of the slave trade and, although British war 
vessels blockaded the coast and were on the lookout for 
slave-traders, the high rate of speed possessed by the ves- 
sels engaged in this nefarious trade and the thorough 
knowledge the marauders had of the many inlets where 
they could find a safe hiding place when the scout-ships 
were sighted, enabled them to navigate the many rivers 
of that section almost unmolested. As most of these slave- 
ships came from Cuba or South America, where yellow 

^^ Berenger-Feraud, loc. cit., p. 122, 

" Statistical Report of tlie Health of the Navy for the Year 
1862 (London, 1865), p. 157. 



166 HISTORY OF YELLOW FEVER. 

fever reigns at almost any season of the year, the yellow 
fever mosquitoes could easily be imported. The only mat- 
ter of surprise is that the disease has not been more fre- 
quently propagated by these vessels. 

1873. 

In 1873, yellow fever was imported to the island of 
Sal, one of the Cape Verds, from Brazil, and thence to 
Benin. Small vessels, laden with grain from South Ameri- 
ca were then in the habit of first stopping at the Cape 
Verd Islands on their way to West Africa, and as yellow 
fever has been epidemic in Brazil almost every year since 
1849, this visitation can surely be attributed to importa- 
tion from that country. 

The first knowledge at Cape Coast Castle of the pres- 
ence of yellow fever in the Bights was late in November, 
on the arrival of the mail packet Amhriz, having the dis- 
ease among her crew.^^ The vessel was at once quaran- 
tined, her mails being put on board the Blafra and both 
vessels steamed off. The Amhriz lost thirteen of her crew 
before she reached the Cape Verds^ and the Blafra six. 
From the meagTe report furnished, this outbreak does not 
appear to have been either extensive or attended with much 
mortality. 

BOA VISTA. 

{See Cape Verd Inlands.) 

^^ Smart: Trans, Epidemiological Society of London, vol, 3, 

p. 507. 



BONNY. 

Description. 

Bonny is a town of West Africa, on the Bonny River. 
Jt is surrounded by a pestilential swamp and is inhabited 
by degraded savages. It does a good exporting business in 
palm oil. It was once the most notorious slave-port in 
Africa. 

YELLOW FEVER YEARS. 

1862; 189L 

SUMMARY OF EPIDEMICS. 

1862. 

The epidemic of 1862 almost deciminated Bonny and 
was as fatal among the blacks as among the few white 
settlers of the colony. The fever was original^ y intro- 
duced by some of the trading vessels plying between Bonny 
and the Cape Verd Islands. Two-thirds of the inhabitants 
of Bonny are said to have perished. Out of a population 
of 140 Europeans, 70 were attacked in the space of a 
month. In one day, as many as twenty bodies were taken 
out of the same house. 

The mortality in the shipping was heavy. The bark 
Phrenologist lost its captain, pilot, first mate and two 
sailors. The ship Gran Bonny lost four men. Between 
April 4 and May 5, there were 62 deaths among the crews 
of vessels at Bonny. ^^ 

"Landa: La Espana Medica, 1863, vol. 8, p. 427; also: Statisti- 
cal Report of the Health of the Navy for the Year 1862 
(London, 1865), p. 157.. 



168 HISTORY OF YELLOW FEVER. 

1891. 

The second recorded outbreak of yellow fever at Bonny 
occurred in 1891. The epidemic lasted from February to 
April. -^ Cases and deaths are not given. As this is the 
only locality in Africa where the fever prevailed in 1891, 
it was probably imported from that prolific source of in- 
fection — Brazil. A glance at the consular reports and re- 
ports of quarantine officers published in the Weekly Ab- 
stracts of Sanitary Reports for 1891, brings out the fact 
that almost every vessel reported as ''infected with yellow 
fever'- during that year originally sailed either from Bahia, 
Kio de Janeiro, Santos, Para, Pernambuco, or other in- 
fected Brazilian ports. It is surprising that, owing to the 
lax quarantine methods then in vogue in Africa, that the 
whole coast was not infected. An explanation will no 
doubt be found in the absence of the festive Calopus from 
the localities which escaped a visitation. 

2° Weekly Abstracts of Sanitary Reports, U. S. P. H. & M. H. 
S., 1891, vol. 6, pp. 266, 298. 



BULAM. 

Description. 

Bulam or Boullam (now called Bulam or Eolama), is 
one of the Bisagos, a group of about thirty islands near 
the west coast of Africa, opposite the mouth of the Kio 
Grande, between lat. 10° and 12° N. The largest of the 
archipelago, Orango, is about 25 miles in length, and most 
of the islets are inhabited by a rude negro race, with whom 
some desultory trade is carried on. Most of the islands 
are under native chiefs, nominally vassals of Portugal. 
At Bulama, once a British settlement, but abandoned as 
unhealthy in 1793, there is a Portuguese town, a thriving 
and pleasant place, the seat of government for the Portu- 
guese possessions in this quarter. 

The earliest description of Bulam is given by the Che- 
valier de Marchais, in Father Labat's Voyages du Cheva- 
lier de Marchais en Guinee et ana; Ties Voisines, vol. 1, p. 
68, of which the following is a translation : ''The bed of 
that river (Sierra Leone) contains a quantity of islands, 
densely Avooded; the soil is rich and produces all that is 
necessary to life. The air is very pure and one is not sub- 
ject to those violent and dangerous diseases which prevail 
on the Coast of Guinea and which are so fatal to Euro- 
peans," , 

Dr. Lind, in his Diseases of Hot Climates^ p. 56, also 
speaks favorably of these islands. 

According to Chisolm,^^ the most correct description of 
the Island of Bulam can be found in the African Plot, a 
paper published by Capt. Norris in 1796 (or thereabouts), 
in which it is stated that ''Boullam'' is located in "latitude 
11° N. and longitude 3° W. from Farro, almost in the 
mouth of the Eio Grande, having Hen Island between it 
and the ocean. It appears to be nearly circular, about 
15 miles long and 15 broad; and, consequently^ about 45 
round." 

^^ An Essay on the Malignant Pestilential Fever introduced into 
the West India Islands from Boullam, etc., by C. Chisolm 
(1799), p. 85, 



170 HISTORY OF YELLOW FEVER. 

YELLOW FEVER YEAR. 
1792. 

A VENERABLE MEDICAL HEIRLOOM. 

The alleged importation of yellow fever by the British 
ship Hankey from Bulam to the island of Grenada, West 
Indies, in 1793, is one of the mustiest heirlooms in the 
annals of medical history. Together with the case of the 
Bann (Island of Ascension, 1823) and that of the Eclair 
(Boa Vista, 1845-6), it forms a triumvirate which, for 
nearly a century, was the cause of most acrimonious con- 
flicts between medical men and gave rise to controversies 
which remain unsettled to this day. The believers in the 
specific nature of yellow fever, headed by Sir William 
Pym, and the "other side," composed of men who upheld 
the theory that the disease should be placed in the same 
category as malarious fevers, wrote books and brochures 
by the score and burdened the columns of the medical 
press of the period with articles which are brimful with 
personalities of the most volcanic type. When, through 
sheer exhaustion, partisans abandoned the fray, fresh re- 
cruits would take up the gauntlet and, imbued with seem- 
ing! v irrepressible hatred, would ''sail in'- with fiendish 
fury and renew hostilities, scattering vituperation right 
and left, without the least regard for age, oificial position 
or facts. 

A specimen of this mode of warfare will prove interest- 
ing. According to the British and Foreign Medico-Chir- 
urgical Revieiu,^^ we find Sir William Pym stating that 
Sir William Burnett and Dr. Bryson, his antagonists, 
''have gone unnecessarily and wantonly out of their way, 
to make unfounded and malicious statements," and giving 
utterance to a pious wish that these gentlemen may profit 
by the information he has given them, and may "pray for- 
giveness for their inconsistencies and misrepresentations." 
He informs us that he has been induced to take up the 
gauntlet again, by the "wanton, false, abusive, and un- 
founded attack" made by Sir William Burnett upon him 

^^Vol. 4, 1849, p. 459! ' 



BULAM. 171 

in reference to the Eclair. On the other side, Dr. Bryson 
accuses Sir William Pym of attacking him ''in most un- 
justifiable and unprofessional language;" of making use 
"of garbled and unfair extracts;" of "disingenuously mix- 
ing up facts and statements in a confused manner, for the 
purpose of making out charges of inconsistency;" and he 
regrets that Sir William Pym's review of his "Ixeport of 
the Diseases of the African Station" "is written in a style 
which prevents his replying to it with the respect due to 
a man of Sir William Pym's age and position in society." 

Other equally amiable diatribes are of record, but we 
will pass them by and revert to the fossilized case under 
discussion. 

HOW BULAM BECAME FAMOUS- 

Up to 1792, Bulam was an unknown quantity m the af- 
fairs of men. It is true that it occupied a place in the 
charts of the bold, but cautious navigators of the time, 
but insofar as its climate and the people which inhabited 
it were concerned, it was as deep a mystery as the North 
Pole is to us at the present writing. How it suddenly 
sprang into world-wide prominence and achieved a noto- 
riety which clings to it to this day, and which gave the 
name of "Bulam Fever" to the nomenclature of yellow 
fever, is faithfully chronicled in Dr. Chisolm's immortal 
work, from which the information which follows is ex- 
cerpted. 

SUMMAKY OF EPIDEMIC. 

According to Dr. Chisolm,^^ the Hankey sailed from 
England, in company with the Calypso, both chartered by 
the Sierra Leone Company, loaded with stores and adven- 
turers for the projected colony at Boullam, about the be- 
ginning of the month of April, 1792. When these ships 
sailed, the crews and passengers were all healthy and con- 
tinued so until they reached their destination. These ad- 
venturers, who were mostly the well-to-do middle class, 
had been induced to settle in this "new country" more 

23Chisolm: loc. cit., p. 83. 



172 HISTORY OF YELLOW VFEER. 

from the delusive prospect of wealth held out to them and 
the fanatic enthusiasm for the abolition of the slave trade, 
than by any deprivation of the means of subsistence in 
their own country. Boullam had been depicted to them 
as an ideal place. When the Hankeij arrived off the 
island, it was found to be unhabitated and lurid tales were 
told by some of the sailors who had been in the neighbor- 
hood before concerning the aborigines who inhabited the 
mainland. They were i)ictured as being ferocious to an 
extraordinary degree and some were even said to be rabid 
cannibals. These rumors unnerved the prospective settlers 
and hindered them from making a permanent landing on 
the island. For nine months they lived on board the 
Hankey. '^The rainy season coming on almost immedi- 
ately after their arrival," observes Dr. Chisolm,-^ ''and the 
heat being at^he same time excessively great, they en- 
deavored to shelter themselves from both by raising the 
sides of the ship several feet, and covering her with a 
woodtn roof.-' 

Amid such cramped and unsanitary surroundings, it is 
not surprising that the worst forms of disease should be 
engendered. We shall continue the recital of this famous 
case, as culled from the Second Report on Quara^itine, 
pages .71 to 83 : 

According to the estimate of Dr, Chisolm, the settlers 
and crew, numbered in all upwards of 200 people, includ- 
ing women and children. These persons, he says, con- 
fined in a sultry, moist atmosphere, inattentive to cleanli- 
ness, and neglecting to sweeten the ship and to destroy 
the clothes, bedding, etc., of those that died, were seized 
with a malignant fever which produced such havoc among 
them that when the time for which the Hankey was char- 
tered had expired, there were no seamen left to navigate 
the ship; and consequently they were obliged to proceed 
to sea. having on board only the captain, who was sick, the 
mate, one of the settlers (Mr. Paiba), and two seamen. It 
is stated that with much difficulty they arrived at St. 
Jago, where they found the Charon and Scorpion, ships 
of war, from each of which they- received two men to as- 
sist them in navigating their vessel; that with this aid 

2'Loc. cit., p. 85. 



BALUM. 173 

they proceeded to the West Indies — a voyage to England 
being impracticable in their state; and that on the third 
day after leaving St. Jago, the four men transferred to 
them from the ships of war, were themsehes seized with 
the fever, two of whom died, and the remaining two Avere 
put on shore at Grenada, ''in the most wretched state pos- 
sible." 

Dr. Chisolm further states tliat Captain Dodd of the 
Charon, having occasion about that time to come to 
Grenada, and hearing of the mischief of which the Hankeij 
had been the cause, mentioned that several of the Charon^s 
and Scorpion^s people Avere sent on board the Hankeij at 
St. Jago to repair her rigging, etc. ; that from this circum- 
stance and the communication Avhich his barge's crew had 
with the ship, the pestilence was brought on board both 
ships; and that of the Gharon^s creAV thirty died; and of 
the Scorpion's about fifteen. 

The Hankeij arrived at the port of St. George on the 
19tli of February. The first person who visited the ship 
after her arriA^al in St. George's Bay Avas Captain Eeming- 
ton an intimate acquaintance of Captain Coxe, the captain 
of the Hankeij . This person went on board of her in the 
evening after she anchored, and remained three days, at 
the end of which time he left St. George's and proceeded 
in a drogher (a coasting A^essel) to Grenville Bay, where 
his ship J the Adventure lay. He was seized Avith the pes- 
tilential fcATr on the passage, and the Adolence of the 
symptoms increased so rapidly as on the third day to put 
an end to his existence. The crcAV of the Defiance, in 
Blythe Port near Newcastle, were the next AA^ho suffered 
by Aisiting this ship ; the mate, boatsAvain, and four sailors 
Avent on board the day after her arrival; the mate re- 
mained either on deck or in the cabin, but the rest went 
below and stayed all night there. All of them were imme- 
diately seized with the fever, and died in three days. The 
mate was also taken ill but recovered. Tlie crew of the 
ship BailUes Avere the next who suffered; these communi- 
cated the infection to the ships nearest them, and so it 
gradually spread from those nearest the mouth of the 
carenage, where the Hankey for some time lay, to those at 



174 HISTORY OF YELLOW FLVER. 

the bottom of it, not one escaping in succeSvSion whatever 
means the captains took to prevent it. 

About the middle of Ax)ril the disease began to appear 
on shore. The first house it showed itself in was that of 
Messrs. Stowewood and Co., situated close to the wharf; 
and the infection was evidently introduced by a negro 
wench who took in sailor's clothes to wash. The whole of 
the family were successively afflicted with it ; and by them 
communicated to all those Avith whom they had any inter- 
cotirse. All who from friendship, business, or duty, com- 
municated with the diseased were themselves infected, and 
no instance occurred wherein the contagion could not be 
traced to its particular sotirce. A few who sedulously 
avoided the houses where the infected actually were, es- 
caped. 

That part of the garrison quartered nearest to where 
the Hankeij lay, were the first of this class of men who re- 
ceived the infection. A barrack containing nearly one-half 
of the tl:5th regiment, was situated exactly to leeward of 
the Hankeij and distant from her about 200 yards. One 
of the officers visited the Hcnikei/, and with two or three 
soldiers who rowed his boat, remained on board some time. 
The consequence of this imprudence was fatal to himself 
almost immediately after, and in a little time, tc many of 
the men. All the officers and men were successively seized 
with the disease; but it proved fatal only to recruits who 
had lately joined. 

About the beginning of May the disease made its ap- 
pearance in the detachment of Eoyal Artillery; a circum- 
stance rather extraordinary, as that corps were quartered 
in a situation far removed from the focus of infection. It 
was evidently prodticed. however by the communication 
which the gunners, doing duty in Fort George, had with 
the 45th regiment. Of 84 people belonging to the ordin- 
ance department at that time, about 56 were seized with 
the disease before the 1st of Jtily, and of these 5 died; a 
trifling mortality, considering the nature of the complaint. 
All these men, however, had been about three years in the 
country, and consequently suffered less from the disease, 
than about 27 recruits who ioined the artlllerv in Julv. 



BULAM. 175 

Of 26 of these unfortunate men who were infected, 21 died 
before the middle of August. 

About the 1st of June, the disease began to appear 
among the negroes of the estates in the neighborhood of 
the toAvn, but it did not spread much among them, nor was 
it marked with the fatality which attended it, when it ap- 
peared among the whites. 

About the middle of June, the disease broke out in the 
6Tth regiment, and among the artificers and laborers on 
Eichmond Hill. The infection was communicated by some 
of the latter, who had visited their friends in town labor- 
ing under it. All w^ere successively seized with it; but it 
fell heavier on the officers than the men, several of the 
former being young men lately arrived from Europe. 

The disease in the course of the months of May, June, 
and July, appeared in several distinct and distant part* 
of the country, W'here the infection was carried by per- 
sons^^ who had imprudently visited infected houses in 
town. 

But the infection was not confined to Grenada alone; 
from this, as a focus, it spread to the other islands; to 
Jamaica, St. Domingo, and Philadelphia, by means of ves- 
sels on board of which the infection was retained by the 
clothes, more especially the w^oollen jackets of the deceased 
sailors.-^ 

Such are the facts of this celebrated legend, on which 
whole libraries have been written. That the Hankey was 
ravaged by yellow fever, there is not the slightest doubt; 
but the disease did not and could not originate at Bulam, 
for the simple reason that it had never prevailed there be- 
fore and has never been observed there since. As yellow 
fever was epidemic at Fernando-Po in 1792^ the Hankey 
was in all probability visited by the commanders and 
crews of the innumerable tramp and semi-piratic ships 
which then infested these waters and, once contaminated, 
acted as firebrands in propagating the pest. 

The statement made by the venerable Chisolm that the 
disease w^hich raged on the Hankey while the ship was in 

^ It is needless to add that we dissent from this view. 
^ Dr. Chisolm evidently had not been introduced to the 
Steg'omyia Calopus. G. A. 



176 HISTORY OF YELLOW FEVER. 

the harbor of George Town was ^'anknown in this coun- 
try"^" is easily refuted by history. A reference to our 
chronological tables and also to the history of yellow 
fever at the island of Grenada, will show that the saffron 
scourge made its first appearance among the inhabitants 
of that island in 1694, antedating by almost a hundred 
years the alleged importation so graphically outlined by 
Chisolm. 

-'Chisolm: Loc. cit, p. 89, 



CALABAR. 

Description. 

Calabar is a maritime district of West Africa, in Upper 
Guinea, between the bights of Benin and Biaffra. The 
native population consists principally of slaves. The cli- 
mate is extremely unhealthy and, with the exception of 
missionaries, there are no white men in the district. 



1862. 



YELLOW FEVEE YEAR. 



SUMMARY OF EPIDEMIC, 



There is a solitary instance of yellow fever having vis- 
ited Calabar. In 1862, according to Berenger-Feraud,^^ 
the disease was introduced into the district, but no details 
are given. As the fever ravaged the whole African coast 
that year, from the Congo to Sierra Leone, it was no doubt 
imported into Calabar by the palm-oil vessels trading 
along the coast. 

^^ Berenger-Feraud, loc. cit., p. 139, 



CANARY ISLANDS. 

Description. 

Canary Islands, or Canaries, are a cluster of islands in 
the Atlantic Ocean, about 60 milts northwest of the Afri- 
can coast, and belong to Spain. They are thirteen in num- 
ber, seven of which are of considerable size, namely, Palma, 
Ferro, Gomera, Teneriffe, Grand Canary, Fuerteventura 
and Lancerota. The other six are very small: Graciosa, 
Roca, Allegranza, Santa Clara, Inferno and Lebos. The 
population of the islands, which is a mixture of Portugese 
and Spanish, is estimated at 300,000. Santa Cruz de Ten- 
eriffC; with a population estimated at 46,000, is tlie capital 
of the group. Las Palmas, with a population of about 
12,512, is the next city in importance. 

Historica I Nummary. 

Two years after the discovery of America, or, to be more 
explicit, in 1494, yellow fever is said to have made its 
debut in the Canaries. No previous record of the appear- 
ance of the disease among the Guanches, the mysterious 
tribe w^hich originally peopled the islands, is in existence. 
This, of itself, is sufficient to forever set at rest the theory 
that yellow fever is an African product, for were this the 
case, the Canaries, which are only about 60 miles from the 
mainland and directly in the path of vessels plying be- 
tween Western Africa and Europe, and were no doubt vis- 
ited by the mediaeval freebooters using this route, would 
certainly have been infected long before 1494. 

The Canaries, which are supposed to be the ^^Fortunate 
Islands" of the ancients, were known to Europeans from 
time immemorial. ^ The elder Pliny speaks of them, but, by 
one of these strange freaks which characterize history, they 
were lost sight of for many centuries and not rediscov- 
ered until 1313, when they were invaded by the Spaniards, 
who retained possession of the islands until 1334, when 
they passed into the hands of the Portugese. In 1402, tlie 
Norman adventurer, Jean de Bethencourt, fitted out an 



CANARY ISLANDS. 1 7^ 

expedition for the purpose of conquering the archipelago. 
He was assisted by the Spanish Crown and succeeded in 
mastering four of the group. After his death, his suc- 
cessor sold all his rights to Spain. In 1477, the King of 
Spain sent out a large force to subdue the Guanches, but 
the natives put up such a brave and stubborn fight, that it 
Avas not until 1495 that the islands were completely sub- 
jugated. The aborigines were nearly extirpated by the 
conquerors and have long ceased to exist as a separate 
people. Of this mysterious race, little is known. They 
are supposed to have been of Lybian or Berber stock, but 
this is only a conjecture. They are said to have been a 
brave, intelligent race, of large stature, and comparatively 
fair and to have been proficient in the making of pottery 
ware. Specimens of their craft are preserved in the 
British museums. 

It is a significant fact that the first recorded introduc- 
tion of yellow fever into the Canaries should be coincident 
with the exodus of the panic-stricken Spaniards from the 
"New World," fleeing from a 7iova pestis, engendering a 
dread which even overshadowed their innate greed for gold 
and conquest. The terror which the new hemisphere in- 
spired began to be manifest about 1494 and not only 
caused hundreds of the adventurers to return to their na- 
tive land, but hindered others from attempting the voyage. 
"Not a single vessel," says Oviedo,^^ "left Spain during^ 
the third voyage of Columbus,^^ because the men who had 
returned with him from San Domingo were of such a sick- 
ly hue, that they resembled corpses." 

Such was the curse of God in atonement for the atroci- 
ties perpetrated by these merciless conquerors upon an in- 
offensive and peace- abiding race, whose only crime was 
that they defended their native land. What the poor 
Guanches could not do, however, was wrought by the pes- 
tilence, and the countless hecatombs which mark the ad- 
vent of the Spaniards in the New World, bear silent wit- 
ness to the merciless work of the avenging spirit. 

'^Goncalo Oviedo: La Historia General de las Indias, 1547, vol. 

2, chap. 4. 
^•^ March. 1496. 



180 HISTORY OF YELLOW FEVER. 

YELLOW FEVER YEAES. 

1494; 1495; 1496; 1512; 1531; 1582; 1599; 1601; 1606; 
1707; 1771; 1772; 1773; 1810; 1811; 1828; 1846; 1847; 
1862; 1888; 1905. 

SUMMARY OF EPIDEMICS. 

1494. 

According to Finlay/^^ a pestileiitial disease, said to be 
yellow fever, appears to have been carried from Hispanola 
( San Domingo ) to tlie Canary Islands in 1494. either by 
the vessels of Antonio Torres, or, more probably, by the 
three which returned to Spain after having landed Don 
Bartolome Colon at Y'sabella, San Domingo. Wliat makes 
this assertion seem still more plausible, is the faei:, record- 
ed by Humboldt^- and Bonpland,"^'^ that what remained of 
the Guanches on the island of Teneriffe perished mostly in 
1494, in the terrible epidemic called the '"Mordora.'' 

1495. 

Oviedo'^^ informs us that the island of Tenerifi'e, one of 
the Canaries, was visited by a great pestilence in 1495, pre- 
sumed to have been imported from Hispanola b;/ the flee- 
ing Spaniards, who stopped at the island on their home- 
ward voyage. This epidemic was undoubtedly yellow 
fever, for the adATnturers who returned home were of a 
^^sickly saffron color"^^ and were so permeated with terror- 

^^Finlay: Reference Handbook of the Medical Sciences (New 
York, 1904), p. 323. 

'- Ibid. 

^Aime Bonpland, French botanist, 1773-1858. While pursuing 
his studies in Paris, he made the acquaintance of Alex- 
ander von Humboldt, the famous historian, and agreed 
to accompany him in his celebrated expedition to the 
New World. During this expedition, he made many valu- 
able botanical discoveries. 

^'Goncalo Oviedo: La Historia General de las Indian, 1547, 
vol. 2, chapter 15. 

^Oviedo: Loc. cit., vol. 2, chap. 4, 



CANARY ISLANDS. 18 I 

that neither promises of gold nor assurances of lordly 
power in the '^New World" could tempt them to cross the 
seas again. 

1496. 

Teneriffe seems to have been again infected in 1496, ac- 
cording to Cornilliac,^^ but whether it was a recrudescence 
of the epidemic of 1495 or a new importation, is left to 
conjecture. 

1512, 

Berenger-Feraud is of the oi)inion that the epidemic 
which reigned in the Canaries in 1512, and which was 
designated by the name of peste, Avas an invasion of yellow 
fever. ^^ 

1531. 

This year Avas also characterized by an outbreak of the 
peste in the archipelago. The authority quoted in the 
preceding paragraph thinks it was yellow fever. ^^ 

1582. 

Half a century elapsed without yellow fever being ob- 
serA^ed in the Canaries. It Avas introduced that year, pre- 
sumably from the West Indies, and is designated by the 
name of peste by the Spanish chroniclers. Berenger- 
Feraud, hoAvever, says it Avas undoubtedly yellow fever.^^ 

1599. 

In 1599, a pestilential disease, designated by the Span- 
iards by the name of ealentura, ravaged the Canaries. 
Towards the end of 1599,^^ the squadron commanded by 

^^ Cornilliac: Reclierches Chronologiques et Historiques sur 
rOrigine et la Propagation de la Pievre Jaune dans les 
Antilles (Fort-de-France, 1867). 
^'Berenger-Feraud, loc. cit., page 38. 
^Ibid. 
2'^' Ibid. 
^'Cop: Histoire de la Medecine Navale Ho'landai!:e. 



182 HISTORY OF YELLOW FEVER. 

Admiral Van der Does, of the Dutch Navj, consisting of 
75 vessels and 8,000 men, made an attack on tho Spanish 
vessels at Corunna, Spain, but meeting with poor success, 
set sail for the West Indies. The vessels stopped at the 
Canaries to harass the Spanish colonists located on the 
islands and were soon afterwards infected by the disease 
then raging in the archipelago. On the admiral's flag-ship 
alone, 15 died. The fever is said to have been brought to 
the Canaries by Spanish vessels returning from San 
Domingo.^^ 

1601. 

The year 1601 witnessed another outbreak of pestilential 
disease in the Canaries. Some chroniclers says it was the 
plague, but Berenger-Feraud^- is of the opinion that it 
was yellow fever. 

1606. 

The Canaries were again afflicted in 1606. Opinions 
are divided as to whether this epidemic was yellow fever 
or the Oriental plague, but Berenger-Feraud thinks it was 
yellow fever. ^^ 

1701. 

For nearly one hundred years — 1606 to 1701 — the 
Canaries were free from yellow fever. Xo explanation of 
this extraordinary immunity for such a long period is 
given by historians, even our old stand-by, Berenger- 
Feraud, whose writings we ahvays consult when "up a 
tree," being as mum as the proverbial clam. Of course, 
we could venture an opinion, but as same could not be 
based upon even a scintilla of fact, it would be valueless. 

In 1701, yellow fever was epidemic in Havana, Barba- 
does, Martinique and the English Antilles, and according 
to Arejula,^* was brought from Havana to the Canaries, 

" Berenger-Feraud, loc, cit, p. 27. 

*^ Berenger-Feraud, loc. cit., p. 38. 

*^ Berenger-Feraud, loc. cit., p. 38. 

**Arejula: Archives de Medecine Navale, Paris, vol. 7, p. 251. 



CANARY ISLANDS. ^ 183 

where it caused a great mortality. As is the case with 
every mention of epidemics of yellow fever during colonial 
days, no details are given. In speaking of this outbreak, 
Berenger-Feraud informs us that elle fit de grarids 
ravages^^^ but says nothing of the number of victims nor 
of the extent of the disease. 

As will be seen by consulting our Chronology, yellow 
fever was also present in Spain in 1701 . 

1771. 

Another prolonged lapse of time took place before yel- 
low fever again visited the Canaries In 1771, a vessel 
from the West Indies, where yellow fever prevailed, in- 
fected the islands.^^. The outbreak was attended with 
much mortality. 

1772. 

A Spanish regiment is said to have brought yellow fever 
from Havana to the Canaries in 1772. Though not as gen- 
eral as the year previous, the epidemic was quite severe.^'^ 

1773. 

A mild epidemic of yellow fever prevailed in the Cana- 
ries in 1773.^^ The source of infection could not be ascer- 
tained. 

1810. 

The year 1810 witnessed another murderous eruption 
of yellow fever on the island of Teneritfe. 

The history of this outbreak is interesting, and goes to 
show how steadily and treacherous is the advent of this 
terrible disease. What makes the circumstance ptill more 
remarkable, is the fact that the Canaries escaped un- 
scathed during the great epidemics which devastated Spain 

^^ "It caused great mortality." 
*^ Berenger-Feraud, loc. cit, p, 55. 
*^ Berenger-Feraud, loc. cit., p. 55. 
** Berenger-Feraud, loc. cit., p. 56. 



184 HISTORV OF YELLOW FEVER. 

in ISOO and 1804 — an iniuiunirT which one can only 
ascribe to Divine Providence, for commnnication between 
the islands and their Mother Country was free and fre- 
quent during the above mentioned years. 

To Spain belong^s the credit of having imported the 
fever to Teneriffe in 1810. The disease was almost general 
in Andalusia, causing much mortality in Cadiz, Barce- 
lona. Carthagena. Seville and Gibraltar. In the l>egiiiiimg 
of October of that year,^^^ a panto ae. or prison-ship, sailed 
from Cadiz with French prisoners on board and landed 
at Santa Cruz de Teneriffe. where the human cargo was 
disembarked and lodged in the town barracks. It is said 
that the i^rison-shiii was a hot-bed of yellow fever, but this 
fact was withheld from the port authorities, and as the 
disease had not been observed on the island since 1773, 
they were lulled by a false sense of secui'ity. About the 
middle of C^ctober, the practitioners of Santa Cruz de 
Teneriffe noticed that there was an unusual number of 
cases of malignant bilious fever and the fact was reported 
to the health authorities. The wai-ning was at first un- 
heeded, but the malady soon liecame so T\idesi)read, that 
an investigation was ordered and it was found by ex- 
perts — men who had already gone through epiiemics of 
yellow fever — that the prevailing sickness presented the 
identical symj)toms which had characterized the disor- 
ders of Andalusia in 1800 and 1801. The authorities 
awoke from their lethargy, but it was too late. The disease 
had sfjread indiscriminately to several quarters of the 
town and preventive measui^es were unable to ch^^ck its de- 
structive progi-ess. To prevent the y^estilence from 
being carried to the other towns of the island, a sanitary 
cordon was established around Santa Cruz de Teneriflfe 
and inti^uctions were sent to the other islands of the archi- 
pelago to take the necessary precautions to prevent the in- 
troduction of the fever. These \)V(.mi)t and rigid measiues 
limited the epidemic to its original *:ite. 

This is the first ej)idemic in the Canaries vvhere definite 
details could be obtained. In each of ihe other Id stances, 
chroniclers speak of *^'the great mortality" caused by the 

** Fellowes : Reports of the PestUential Disorders of Andalasia 
(London, 1S15), p. 230. 



CANARY ISLANDS. 185 

disease or that the inhabitants ''died by thousands," but 
here we have cold-blooded statistics, carefully compiled, 
which give an intelligent and comprehensive resume of 
the visitation. 

The total number of cases in the epidemic of 1810 at 
Santa Cruz de Teneriff e is said to have been 5,000 ; deaths, 
1,150. The estimated population of the town at the time 
of the outbreai^ Avas 12,000. 



1811. 



The epidemic of 1811 was still more disastrous than 
that of 1810. How the disease originated, our ; ources of 
information (Moreau de Jonnes,^^ Fellowes^^ and Beren- 
ger-Feraud^^) fail to enlighten us, but the mortality is 
said to have been great. In San Juan Orotava, on the 
island of Teneriffe, which had then a population of 3,000, 
there were 500 fatalities. In the island of Grand Canary, 
there were over 3,000 deaths. 



1828. 



During the summer of 1828. yellow fever was brought 
from 'Spain to the Canaries. ^^ The outbreak was not gen- 
eral, but it claimed many victims. 

1847. 

In 1847, we must look to America for importation of 
yellow fever to the Canaries. The outbreak does not ap- 
pear to have been virulent, however, for out of a total of 
5,000 cases, a mortality of only 60 i« recorded.^^ 

We doubt that this was yellow fever. 



^''Morea de Jonnes: Monographie Historiqiie et Medicale de 

la Fievre Jaune des Antilles (Paris, 1820), p.. 342. 
^^Fellowes: Loc. cit, 
*=* Berenger-Feraud : Loc. cit., p. 83. 
"■^ Berenger-Feraud, loc. cit., p. 106. 
'^Ibid., p. 116. 



ISo HISTORY OF YELLOW FIVER. 

1862. 

The Si)anisl:; frigate Xiraria i^aHed from Havana on 
June 30, 1862, after being in port thirty clays. The vessel 
arrivei at Vigo, Spain, in the beginning of July. The 
authorities were informed that there had been a death 
from yellow fever on the frigate shortly after her depart- 
ure from Havana, and as the disease was known to be epi- 
demic at that port and it was feared that other cases 
would break otit, the captain was ordered to proceed to 
the quarantine station, where the vessel was thoroughly 
ftimigated and retained eight days. She was then per- 
mitted to proceed to her destination and arrived at Santa 
Cruz de Teneriffe, where she wa> imprudently admitted 
to free praHqne. There had been no new cases since the 
death on the way from Havana and the health authorities 
of the island thought that all danger vras «^.ver. The crew 
had hardly started discharging the cargo, when two of 
them were taken ill and died shortly afterwards, with all 
the symptoms of yellow fever. Stringent precautions were 
taken, and, for some time, no other cases manifested them- 
selves; but on October 2, Valentin Zamora, who had com- 
municated with the vessel, was stricken and died after an 
illness of seven days. Cases began to show themselves here 
and there in the immediate neighborhood of the shipping 
and then suddenly spread throughout the town. A panic 
ensued. Almost the entire population fled to the interior 
of the island, only about 3.000 remaining. The epidemic 
lasted until th^ beginning of 1863, resulting in 2,600 cases 
and 380 deaths.^^ 

The Xivaria was engaged in transporting arms to Cuba. 

18G3. 

The epidemic which began in 1SG2 did not subside until 
the beginning of 1863, after which the public health re- 
sumed its normal state. 

"Landa: Espana Medica, Madrid, 1863, vol. S, pp. 377, 395, 
411, 427, 442, 475, 491. 



CANARY ISLANDS. 187 

Interesting accounts of this epidemic are given by Do 
Valle,'^^ Berenger-Feraud^^ and Landa.^^ 

18S8. 

In 1888, Santa Cruz de las Pabnas, capital of the island 
of Palma, experienced a stubborn epidemic of yellow 
fever, which, though not attended with much mortality, 
caused great uneasiness throughout the archipelago, owing 
to the difficulty which the authorities encountered in their 
attemjjts to stamp out the disease. Even as late as De- 
cember 17, 1888, the island of Palma was still un'^Jer strict 
quarantine, having been totally isolated from the rest of 
the group by the Spanish Government. ^^ These precau- 
tionary measures confined the disease to Palma. We have 
been unable to obtain more definite details concerning this 
outbreak. 

1905. 

The melancholy history of yellow fever in the Canaries, 
extending over a period of four hundred and eleven years, 
closes with a case of the disease on board the Spanish 
steamship Montevideo^ June 30; 1905, in the harbor of 
Santa Cruz de Teneriffe.^^ Fortunately for the islanders, 
who had paid dearly in the past for neglecting precaution- 
ary measures, the vessel was not allowed to communicate 
with the shore, not even her mails being landed, but was 
remanded to Port Mahon quarantine station, where she 
remained until all danger of contamination was past. 
The patient recovered and no other cases developed on 
board the steamship. The Montevideo had been infected 
at Colon, Isthmus of Panama, from which port she ori- 
ginally sailed. 

'^Do Valle: Echoliaste Medicale, Lisbon, 1864, vol. 15, p. 6. 

" Berenger-Feraud, p. 139. 

"^^Landa: Siglo Medical, Madrid, 1863, vol. 10, pp. 339, 375, 

403, 418, 434, 451. 
=" Weekly Abstracts of Sanitary Reports, 1888, vol. 3, p. 296; 

Ibid., 1889, vol. 4, p. 2. 
^° U. S. Public Health Reports, 1905, vol. 20, pp. 1511, 2770. 



188 HISTORY OF YELLOW FETER. 

Another infected vessel arrived at Santa Cruz de Ten- 
eriffe on November 1, 1905.^^ The captain reported the 
death from yellow fever of a passenger who had taken 
passage for Spain at Sabanilla, Colombia^ and who was 
buried at sea three days after the vessel had left San 
Juan, Porto Eico. On arrival at Teneriffe. the steamer 
was not admitted to pratique, but proceeded to Spain for 
quarantine and fumigation, IS'o other cases occurred on 
board. 

«^Ibid., p. 2628.. 



CAPE VERD ISLANDS. 

Description. 

The Cape Verd Islands (Portugese IlJios Yerdes, i, e., 
''green islands'-) are a group of fourteen volcanic islands 
and rocks, situated off the coast of Africa^ in the xAtlantic 
Ocean, 320 miles west of Cape Verd. The archipelago con- 
sists of the folloAving islands : Sal, Boa Yista^ Mayo, San- 
tiago, Fogo, Brava, Grando, Bombo, Sao Mcolao, Santa 
Luzia, Branco, Razo, Sao Vincente and Santo Antonio; 
also, several smaller islets. Area, 1680 square miles. The 
group belongs to Portugal and together with the Portugese 
possessions on the mainland of Africa, constitute the pro- 
vince of Cape Yerde, the capital of which is Porto Pra^^a. 

Historical Sumniari/. 

The Cape Yerd Islands were discovered in 1441 by the 
Portugese, who colonized them. The population is quiet 
and docile, but extremely indolent. The first invasion of 
yellow fever is said to have taken place in 1510, and to 
have lasted for several years after that date; but the re- 
port does not bear the seal of authenticity. Although 
within the geographical limits of yellow fever, the archi- 
pelago has been visited by the disease only at infrequent 
intervals, and but for the epidemic of 1845^ would have 
been sufficiently disposed of with half a dozen lines. It 
has been thought very extraordinary by observers that 
these islands, situated in the direct path of vessels coming 
from localities where yellow fever is perenialh present, 
should not have been frequently ravaged by the scourge; 
but, with the exception of the islands of San lago and Boa 
Vista, the group has been remarkably free from the disease. 

YELLOW FEVER YEARS. 

1510; 1511; 1512; 1513; 1514; 1515; 1639; 1807; 1821; 

1822; 1827; 1837; 1838; 1845; 1847; 1862; 1864; 1868; 
1873. 



190 HISTORY OF YELLOW FEVER. 

SUMMAEY OP EPIDEMICS. 

1510 to 1515. 

Berenger-Feraud,^^ quoting Valkenaer (vol. 1, p. 370), 
says that yellow fever prevailed at the Cape Verd Islands 
from 1510 to 1514. No details as to how the disease was 
brought to the islands or the extent of the invasion, could 
be obtained. The mortality is said to have been consider- 
able on the vessels stopping at the archipelago during 
these years, on their way from Europe to the West Indies 
and vice-versa. 

1639. 

One hundred and twenty-four years elapsed without yel 
low fever being noticed at the Cape Verd islands. In 1639, 
the Spanish fleet, on its way to Brazil, stopped at the 
islands and is said to have been contaminated by a pestil- 
ential disease, which carried off 3,000 soldiers. (Berenger- 
Feraud, p. 27.) The disease is said to have been yellow 
fever, but how it reached the Cape Verds, history does not 
informs us. It is worthy of note, however, that yellow 
fever made its initial appearance in Brazil in 1640 and it 
is plausible to incriminate the Cape Verds in this out- 
break. 

1778. 

According to Boudin, yellow fever prevailed in the 
island of Santiago in 1778. He gives the testimony of Dr. 
Eochard, surgeon of the French frigate Consolante^ who 
states that his ship stopped for a week at Santiago in the 
latter part of 1778. He was told by the inhabitants that 
they were just recovering from an invasion of yellow 
fever. What gives additional creden:^e to this statement, 
is the fact that, a few days after leaving the island, yellow 
fever broke out on board the Consolante, resulting in the 
death of 150 seamen in the short space of five weeks.^^ 

^- Berenger-Feraud, loc. cit., p. 26. 

®^ Boudin: Traite de Geographie et de Statistique Medicales 
d-es Maladies Endemiques, Paris, 1857; Cornilliac, La 
Fievre Jaune Dans le Antilles, 1886, p. 445. 



CAPE VERD ISLANDS. 191 

The report does not state how and whence the disease 
came to Santiago, but as yellow fever was epidemic in 
Senegal, Sierra Leone, the Gold Coast and Gambia in 1778, 
we can safely incriminate Africa, 

1821. 

From 1778 to 1821 the islands were free from epidemic 
disease. In 1821, according to M'Williams,^^ an outbreak 
of the fever took place, but was not attended with much 
mortality. 

1822. 

In 1822, another mild outbreak took place.^^ No details 
are obtainable. 

1827. 

YelloAV fever was imported to Santiago in 1827, pre- 
sumably by a ship from America. The mortality was 
very great. Among the victims were the British Consul 
and some of the members of his family. The American 
Consul, who was then just recovering from an attack of 
the fever, took charge of both consulates. The British 
ship Tioeed, which was on its way to the Cape of Good 
Hope Station, touched at San Jago and a party of junior 
officers went on shore. These were all attacked with fever 
and, with one exception, died. The Portugese troops were 
decemated.^^ 

1833. 

There was a mild outbreak in 1833.^^ 

1837. 

In 1837, yellow fever ravaged the whole coast of Guinea 
and was imported to the Cape Verds,^^ where H caused 
much mortalitv. 



^* Second Report on Quarantine (1852), p,. 110. 
^McWilliams: Second Report on Quarantine, p. 110. 
*^Ibid.; also: Lancet, London, 1848, vol. 1, p. 52. 
" Berenger-Feraud, p. 108. 
^Ibid., p. 109. 



192 HISTORY OF YELLOW FEVER. 

1815. 

The Famous Case of the ^'Eclair /^ 

The epidemic of 1845 furnishes the first intelligent and 
comprehensiye report of yellow fever in the Cape Yerd 
archipelago. This outbreak, which was confined to the 
island of Boa Vista, was considered at the time the car- 
dinal point in the discussion of the contagiousness of yel- 
low fever. All the acrimony which had been smouldering 
broke out afresh and the honorable and dignified medical 
men arrayed on both sides renewed the conflict with 
greater frenzy and venom. The controversy, which had 
begun with the epidemic of Philadelphia in 1793, had 
bobbed up again when the Spanish disorders of 1800-1801 
took phice, had been once more rejuvenated by the Bann 
episode at Ascension in 1823, was gone all over again and 
made still wider the breach between the rabVl contngionists 
and their opponents. 

As this is another cause celehre in the annals of epi- 
demiology, we will give it generous ejjace. The facts are 
as follows :^^ 

On July 23, 1815, the British ship Eclair sailed from 
Sierra Leone, which seems to have been the natural source 
of infection during the last century, and reached Boa 
Vista in August of the same year. During the voyage, 60 
of the crew died of yellow fever. According to the testi- 
mony of Dr. Xavier de Almeida, who went to practice 
medicine in Boa Vista in 1809 and was the only resident 
physician of the island for thirty-eight years, yellow fever 
had not been seen in the vicinity for nearly fifty years pre- 
vious to the arrival of the Eclair. The disease ^as, there- 
fore, undeniably imi^orteel by the infected ship 

While at Boa Vista the officers and crew of the Eclair 
mingled freely with the inhabitants and when the ship 
finally weighed anchor, she left the nucleus of the epi- 
demic in the towns of Eabil and Porto Sal Key. Of the 
three soldiers who constituted the guard at the fort when 
the vessel left the island, two, a corporal and a private, 

*' British and Foreign Medico-Chirurgical Review, 184S, vol. 2, 
p. 164. 



CAPE VERD ISLANDS. 193 

Avere stricken with the disease. They died on September 
22d, after an illness of five or six days. The surviving 
private of this guard, being attacked with a high fever 
some days after this, was removed, together wirh a sick 
comrade, to a small hut at Pao de Verelia. Here the 
stricken men Avere visited and nursed by a Avoman named 
Anna Galinha, AA'ho also contracted the disease and died 
on the 16th of October. The scourge subsequently spread 
through the toAvn and committed much haA'oc. 

The case of Louis Pathi, a laborer of Eabil, who Avas 
taken ill after having Avorked for tAvo days on board the 
Eclair is of pathetic interest, cA^en at this late date, sixty- 
three years after the occurrence. We quote the folloAving 
from the report of Dr. McWilliams, Avho Avas sent by the 
British GoA^ernment to investigate the origin and cause of 
the epidemic :'*^ 

Testimony of Louis Pathi. 

Q. HoAV long Avere you employed on board the Eclair? 

A. About eight days. 

Q. What family haA^e you? 

A. I liaA^e none left.' 

Q. What family had you? 

A. I had a aa ife and three children. 

Q. Did they all die of fever? 

A. Yes, all of them. 

Q. Were you attacked? 

A. Yes; I AA^as first attacked. 

Q. When Avere you attacked? 

A. Three days after I went to Rabil from the ship. 

Q. You were Avith vour family AA-lien you were taken 
sick? 

A. Xo ; I was at Moradinha, 

Q. How long did you stay at Moradinha? 

A. I Avas there eight days, sick. 

Q. What did you complain of? 

A. I had general fcA'^er, headache, pain of back and 
limbs ; A^ery sick. 

^° Report on the Fever at Boa Vista, by J. O. McWilliam, Lon- 
don, 1847. 



194- iIISTORY OF YELLOW FEVER. 

Q. How long were jou sick after return to your own 
house? 

A. Xearly three weeks. 

Q. Who, after yourself, was first taken ill? 

A. My daughter, 12 years of age. 

Q. How long after your return from the Eclair f 

A. It was in the beginning of October. 

Q. Who was next attacked? 

A. Another girl, 7 years of age, four days after the first 
died. 

Q. ATho was next? 

A. My boy, 11 years of age. He was taken ill eight 
days after the second girl died. 

Q. And your wife last? 

A. Yes ; my wife was taken ill the same day as the last 
of the children died. 

A melancholy sequel to the above happened in the home 
of Mauoel Fachina, who lived next door to Pathi' and who, 
together with his wife, nursed the stricken fami];^ . After 
the death of Pathi's wife, the Fachinas were taken sick 
with the fever, but recovered. Their child caught the dis- 
ease and died in three days. 

We find the Eclair again j)laying the role of importa- 
tionist in 1816. After the melancholy experience she had 
undergone in 1815, the ship was sent to the navy-yard at 
Plymotith, England, where she was thoroughly cleaned 
and repainted and given the name of Eosamond.'^ She 
was put in commission and left England for the Cape of 
Good Hope in February, 1816. 

1817. 

Yellow fever is said to have prevailed at the Cape Yerds 
in 1817, but whether it was a recrudescence of the previ- 
ous visitation or a new importation, our source of informa- 

'' For fuller details, see notice of epidemic at Island of Ascen- 
sion in 1846, page 152 of this volume. 



CAPE VERB ISLANDS. 195 

tion'''- does not say. It is claimed that the British ship 
Grotcler Avas contaminated at the Cape Verds and brought 
the disease to Barbadoes. 

1862. 

1862 was a disastrous yellow fever year in Africa. Al- 
most the entire coast, from Senegal to St. Paul de Loanda 
and the Cape Yerd and Canary Islands, suffered from the 
disease. '^^ The outbreak was not very severe at tlie Cape 
Yerds. 

1864. 

The Cape Yerds were again invaded in 1864,^'* but no 
details are obtainable. 

1868. 

In 1868, yellow fever was imported to the Cape Yerds 
from French colonies of the West Coast of Africa, Goree 
and Senegal, and made its first appearance in Bissam.'^^ 
The epidemic was most severe in the city of Praia, in the 
island of Santiago. Commencing in the middle of July, 
1868, the disease spread with such rapidity that a very 
large proportion of the European inhabitants became suc- 
cessively or simultaneously affected, so much so, that dur- 
ing the month of August there were received into the 
Military Hospital at Misericordia no less than 285 cases, 
of which, by September 1, 41 had proved fatal. During 
the month of October, there was a considerable decline of 
the epidemic, the affected persons being those who came 
from the interior of the island of Santiago or other 
points. The disease, however, spread to the island of 
Braza. one of the first victims being the medical officer, 
Theophilio Joaquim Yieiria. There were also some cases 
in individuals who had fled from the city of Praia to other 

'- Berenger-Feraud, p, 118. 

^^'Ibid., p. 139. 

^*Ibid., p. 141. 

^'' Medical Times and Gazette, London, 1869, vol. 1, p. 119. 



196 HISTORY OF YELLOW FEVER. 

points of the island of Santiago. Nearly the whole med- 
ical staff stationed on the island suffered, Senor Pimenta, 
of the Pharmaceutical Branch, succumbing from the 
disease. 

1873. 

In 1873, 3^ellow fever was imported to the Cape Verds, 
presumably from Brazil.'^^ The invasion was confined_ to 
the island of Sal, where the fever ran a mild course during 
the summer months. Sal was put under strict quarantine, 
the authorities prohibiting any communication whatever 
with the rest of the archipelago, and to this sanitary pre- 
caution is no doubt due the small extent of the outbreak. 
The mortality was small. 

There is no other record of any invasion of yellOAV fever 
in the Cape Verd archipelago after 1873. The general use 
of steam-power and the strict attention given id ventila- 
tion and hygiene in the construction of vessels at present, 
has done much to destroy the breeding places of the mos- 
quitoes in the holds of sea- going craft and thus given a 
quietus to the importation of the saffron pestilence. 

^® Smart: Transactions Epidemiological Society of London, vol. 
3, p. 508. 



CONGO COAST. 

DescriptiGn. 

The Congo Coast was formerly under stcod t • embrace 
all the countries on the West coast of Africa be (ween the 
equator and latitude 18° South, but is now restricted to 
the northernmost district of the Portugese colony of An- 
gola. Cabinda, with a population of 8,000, is the capital. 

YELLOW FEYEK YEAES. 

1816; 1860; 1862; 1900. 

suMMAKY OF epide::\iicr, 

1816. 

A Memorahle Expedition and its BisaHirou-j End. 

The history of the first invasion of the Congo by yellow 
fever reads like a romance. We have been much interested 
in the quaint account of the famous Tuckey expedition, 
published in an old hybrid French medical journal long 
since defunct and forgotten, and give in the following 
lines a faithful translation.'^'^ 

In the beginning of 1816, the British Government fitted 
out an expedition to explore the Congo River, under the 
leadership of Captain J. K. Tuckey, an experienred navi- 
gator. Among tho^e who cast their fortunes with the un- 
dertaking, were Dr. Tudor, Messrs. Smith, Lockhart and 
Cranch, naturalists, a few less noted gentlemen in search 
of adventure, and a crew of twenty picked men. 

The expedition consisted of the schooner Congo and 
the transport Dorothea, and left England about the middle 
of March, 1816. On account of contrary winds, slow pro- 
gress was made. The vessels touched at Porto-Pra^^a, one 
of the Cape Yerd Islands, where they remained a few 

" Moreau de Jonnes: Nouveau JourDal de Medecine, Chirurgie, 
Pharmacie, etc., Paris, 1822, vol. 44, p, 330. 



198 HISTORY OF YELLOW FSVER. 

days, and then proceeded to the mouth of the Congo, where 
they anchored in the beginning of July, three months and 
a half after their departure from England. 

On July 8, 1816, the explorers ente^'ed the Congo. Pro- 
gress Ayas slow, as the current was rapid and tr<acherous 
and when about 30 miles up the stream, the Dorothea, 
being found too unwieldy to attempt the ascent unassist- 
ed, was taken in tow by i\\Q Congo. When tlie yillage of 
Embomma was reached, about 75 miles from the mouth of 
the riyer. Captain Tuckey concluded that this mode of 
yoyaging was too slow and dangerous and decided to leaye 
the yessels at anchorage near the town, and to proceed by 
row-boat or by foot in quest of the source of the riyer. 

On August 5, the little party left Embomma. They 
were in fine spirits and splendid health and for the first 
eleyen days of the arduous journey experienced no mis- 
hap. On August 9, they reached the cataract of Yellala, 
which extends across the entire bed of the riyer, and the 
boats had to be abandoned. It was then that the explorers 
encountered their first set-back. Dr. Tudor^ the youngest 
member of the party, was taken ill with feytr. He insisted 
on going on, but had to be carried by his companions. On 
the 16th the naturalist Cranch and seyeral other members 
of the party haying been attacked by feyer, Captain 
Tuckey sent all the sick, including Dr. Tudor, back to 
Embomma, which place they reached on August 22, or 
fourteen days after the doctor had experienced the first 
symptoms of his illness. With only a handful of men left, 
Captain Tuckey brayely perseyered in his quest, but on 
September 9th, when about 160 miles from the mouth of 
the riyer, he was forced to turn back, as nearly eyery mem- 
ber of the little hand was sick with feyer and further 
progress was impossible. When the footsore trayelers 
finally reached Embomma, they found that Dr. Tudor had 
died on August 29 and that the balance of their com- 
panions had either perished or were in a dying condition. 
When the epidemic had subsided, it was found" that out of 
sixty-one robust men who had left England on this fhteful 
expedition, only forty were left aliye, twenty-on:: haying 
fallen yictims to the terrible malady, incladino- Captain 
Tuckey, Dr. Tudor and the three Aaturalists who had 



CONGO COAST. 199 

braved the dangers of a tropical climate in the interest of 
science. 

Tliub came to an end the historic Tuckey expedition, on 
which England had counted so much and which cast such 
a gloom over the civilized world, that fifty years elapsed 
before the Congo was again navigated by white men.'^^ 

An interesting question presents itself: Was the sick- 
ness Avliich made such ravages among the little band of 
adventurers led by Captain Tuckey yellow fever, or the 
endemic pernicious fever of the Congo region? 

Let us anaWze the situation : When the Dorothea and 
the Congo anchored off the mouth of the great African 
river, there Avas no sickness on either vessel ; the health of 
the party was also excellent on August 5, nearly a month 
afterAvards, aaIicu the vessels Avere left at anchorage at 
Embomma. Some historians claim that the vessels were 
infected at Porta-Praya.'^^ Admitting, for the sake of 
argument, that an epidemic disease Avas raging at the 
Cape Yerd Islands Avlien the vessels stopped at Porto- 
Praya, the long period which elapsed between that time 
and the day young Tudor Avas taken ill (almost four 
months), precludes bej^ond doubt the theory of infection 
from these islands. 

Dr. Tudor, the first of the party to be attacked, was 
taken ill on August 9 and died on the 29tk of the same 
month. Admitting that the young man dieJ of the disease 
which showed its first symptoms on the 9th, it Avill be seen 
that he fought against its insidious inroads for twenty 
days, Avhich is far beyond the usual run of the violent 
tropical fcA'Crs endemic to West Africa; but if we simply 
admit that he was originally attacked by the local fever 
on the 9th and that, Avhile still Aveak and jjrostrated, con- 
tracted the pestilential fcA^er AAiiich tben reigned at the 
mouth of the Congo on his arrival there on August 22d, it 
will be seen that only scA^en days elapsed betAveen his ar- 
rival on board the Congo j, Avhere several deaths had already 
occurred from a disease resembling yellow fcA^er, and his 

■'^ Livingstone, 1867. 

"According to the various authors we have consulted, yellow 

fever was never observed in the Cape Verd Islands from 

1516 to 1821.— G. A. 



200 HISTORY OF YELLOW FEVER. 

death, August 29th. As yellow fever is generally fatal on 
the sixth day, it does not require volumes of argument to 
arrive at the conclusion that the pestilential fever which 
almost annihilated the intrepid explorers^ was yellow 
fever. 

^^But," we hear some astute disputant observer, '%s it 
has never been proved that yellow fever ever originated in 
Africa, but was always imported to its shores, whence the 
infection in this particular instance?" 

The services of a medical Sherlock Holmes are not 
ne^^ded to solve this problem. 

The theory of infection from the Cape Verd Islands 
has already been disposed of. We must look elsewhere, 
and experience leads us to that natural hot-bed of yellow 
fever, the West Indies. Let us see what were the hygienic 
conditions of the Antilles in 1816 : 

A cursory reference to the works of Moreau dt Jonnes, 
Amic, Berenger-Feraud, Musgrave Keating, and numer- 
ous other chroniclers who have written on the subject, 
shows that yellow fever was quite prevalent in the West 
Indies in 1816. It prevailed with much severity at Mar- 
tinique and also ravaged Antigua, Barbadoes, Guadeloupe, 
and St. Thomas. 

Here we have a repetition of v/hat has happened again 
and again since the discovery of America. 

The traffic in slaves was quite extensive in 1816, the 
agents of the Spanish Government making bold and fre- 
quent raids on the African coast in quest of unfortunate 
blacks to work their plantations in tbe West Indies and 
South America. In spite of the vigilance of the English 
scout-ships, these marauders, coming from countries in- 
fested with yellow fever, sailed up the many wide estu- 
aries which indent the coast and acted as a firebrand in 
disseminating the seeds of pestilence. 

We have spoken of this in relating the histories of the 
epidemics of the Canary and Cape Yerd islands and 
hope the reader will pardon us if we prove irksome in our 
efforts to take advantage of every fact we can gather to 
prove that yellow fever is not an Africati product, but has 
always been imported to that continent. 

Let us now return to the unfortunate adventurers : 



CONGO COAST. 201 

It will be remembered that the explorers finally reached 
the Congo in the beginning of Jnly. According tu Moreau 
de Jonnes,^^ seven persons on board the Dorothea and one 
or two on the Congo were ill with fever during the long 
jonrne,^ from England to the Congo Coast, due to expos- 
ure. No serious after-effects ensued and the health of the 
voyagers continued excellent. 

We have read every line of the exhaustive article by 
Moreau de Jonnes in the Journal de Medecine above cited 
— seventeen pages — but nowhere find mention that the. ex- 
plorers met with any vessel, stopped at any port v>r mingled 
with any strangers from the time they left England until 
they entered the Congo, save the solitary instance of the 
brief stay at Port:-Praya. As the vessels could possibly 
not have been infe-^ted at that port, we were at a loss to 
locate the original focus, when we came across a short 
account of the epidemic in the scholarly work cf Eerenger- 
Feraud, which clears the mystery. It is certainly peculiar 
that such a close observer as Moreau de Jonnes makes no 
mention of this fact, but as the authorities quoted are un- 
assailable, it deserves a tardy, but merited place in history. 

A perusal of the article by Berenger-Feraud^^ reveals 
the fact that while riding at anchor at the mouth of the 
Congo, Captain Tuckey's vessels were in frequent com- 
munication with the officers and crew of a foreign vessel 
flying the American flag, but which was afterwards found 
to be a Spanish slave-ship from Brazil. There were some 
suspicious cases of fever on board the stranger, but, being 
informed that the craft had come direct from the United 
States, Captain Tuckey had no suspicion of the nature 
of the illness prevailing on board and allcvred free com- 
munication between the complement of the three vessels, 
as he was anxious to obtain all the information he could 
about the mysterious river he was about to explore and 
did not wish to offend the ncAvcomers^ who seemed to be 
well-versed in the topography of the country. Alas for 
human short-sightedness and ambition! This want of 
caution undoubtedly paved the way for the terrible afflic- 
tion which afterwards annihilated the I'ttle band of 

^'^Loc. cit, p. 332. 

" Berenger-Feraud, loc. cit., p. 87. 



%02 HISTORY OF YELLOW FEVER. 

pioneer explorers and deprived science of some of its most 
enthusiastic devotees. 

1860. 

Yellow fever prevailed quite extensively along the Congo 
Coast in 1860 and was particularly severe at Angola and 
St. Paul de Loanda.^^ The source of importation is not 
given. 

1862. 

In 1862, yellow fever invaded alm.ost the entire African 
coast from Sierra Leona to Saint Paul de Loanda. (Ber- 
enger-Feraud, p. 139.) The epidemic, though widespread, 
was not very severe. 

1865. 

The epidemic of 1865 was mild and was not attended 
with much mortality. Berenger Feraud (page 141) only 
makes a brief mention of the incident. 

1900. 

In 1900 yellow fever was imported from Senegal to the 
French Congo. ^^ 

On May 26, the steamship Ville de Pernamhuco, plying 
between France, West Africa and Brazil, stopped at 
Dakar where yellow fever was prevailing. While riding 
at anchor, three sisters of charity who were on board the 
vessel exchanged greetings with members of their order 
who had come to the wharf to see them. It is claimed that 
no other communication Avas had with the inhabitants of 
Dakar, but the statement must be taken cum granis salis. 
The vessel left Senegal for the usual voyage down the coast 
and arrived at Loango, one of the ports of the French 
Congo, on June 15th, where the sisters disembarked. They 
were all successively taken ill. One of the sisters died on 
June 20th and another on Julv 2d. The third recovered. 



*- Berenger-Feraud, p.. 136. 

^^Kermorgant: Receuil des Trav. du Com. Con. d'Hyg. Pub. de 
France, 1901 (Paris, 1903), vol. 33, p. 394. 



CONGO COAST. 203 

Autopsies revealed the fact that the two deaths had been 
caused by yellow fever. 

The fourth case at Loani^o manifested itself in the per- 
son of a young negress aged 16; who had nursed the sister 
of, charity that recovered. The patient died a few days 
later, with black vomit. The i)ort physician took extra- 
ordinary precautions to prevent a spread of the disease, 
which was confined to the cases above mentioned. 

A! remarkable feature of this invasion, is that the only 
person infected by the sisters was a native Af lican and 
that the few whites in the town escaped an attack. The 
natives of Western Africa are generally immune and the 
rare occurrence of a case among them certainly deserves 
special mention. 

This is the fifth and last authentic instance of yellow 
fever on the Congo Coast ; but other visitations of the dis- 
ease no doubt took place before^ between and after the 
dates chronicled in this history, for it is a notorious fact 
that St. Paul de Loanda was one of the most infamous cen- 
tres of the slave-trade in by-gone days and was frequented 
by the worst class of trans-oceanic freebooters. 



DAHOMEY. 

Description. 

Dahomey is a negro kingdom of Weste? n Africa, in 
Guinea, with a coast-line only 35 miles in length, nearly 
the whole of which is composed of islands and swamps. 
The natives are all pagans and their worship fetishism. 
Population, 250,000, of which 230^00 are said to be slaves. 

YELLOW FEVEE YEAES. 

1905; 1906; 1907. 

SUMMAEY OF EPIDEMICS. 

1905. 

Yellow fever had nev^r been observed in Dahomey pre- 
vious to 1905. The immunity of this negro kingdom from 
the disease is easily understood, when one reflects that it 
is hardly ever visited by white men. How the fever was 
imported, we were unable to ascertain, owing to the diffi- 
culty of obtaining information from a region governed by 
savages and only exploited by white men when in quest of 
wild animals for circuses and zoological gardens. Com- 
munication between the European settlements on the coast- 
line of Dahomey and other African ports are frequent and 
uninterrupted. The fact that the first cases were observed 
in the persons of customhouse employes at Grand-Popo, 
giA^es weight to the Iwpothesis that the disease was con- 
tracted on shipboard, as the duties of these officers also in- 
clude the sanitation of vessels coming from foreign ports. 
They w^re thus compelled to spend much of their time on 
"suspicious vessels" and were thus exposed to infection. 

According to the report of the "Gouvernement General 
de FAfrique Occidentale Francaise," ijublished in the 
Annalcs d^Hygiene et de Medecine Coloiviales, Paris, 1907, 
vol. 10, page 449, the first case erupted at Grand-Popo in 
January, 1905, in the person of an old customhouse in- 



DAMOHEY. 205 

spector. The patient died four days after the onset of the 
fever. 

Fifteen days later, another customhouse inspector, a 
young man aged 28, who had recently arrived from France, 
was stricken. Death ensued in a few days. 

The third case, a nun, also ended fatally. 

The bishop of the colony, Avho had nursed the nun, was 
next attacked and furnished the fourth victim. His death 
occurred at Ouidah, where he had gone Avhen he felt indis- 
posed. 

In less than a month, nine additional cases erupted in 
Grand-Popo, six of whom died. 

Thrown into consternation by the rapid and malignant 
nature of the fever which Avas decimating their ranks in 
such a short space of time (six AA^eeks), the handful of 
Europeans Avliich had been spared by the scourge (about 
14), fled to France. Only six or seven Avhites, AAhose offi- 
cial duties prcA^ented them from deserting their posts re- 
mained in the toAvn. Great precautions Avere taken by this 
little band against infection. The Colonial GoA^ernment 
had their living apartments thoroughl^^ screened and they 
Avere especially instructed to Avage an incessant Avarfare 
against mosquitoes. These precautionary measures put an 
end to the epidemic, as no other cases erupted after the 
exodus of the colonists. 

If one takes into cbnsideration the comparatively lim- 
ited population of Grand-Popo and its environs (30 or 
35), the number of cases (13, folloAved by 10 deaths), 
shows that the fcA^er Avas decidedly malignant and Avould 
certainly have been more fatal had the segregation of the 
population not taken place. 

1906. 

One of the strange characteristics of yellow fcA^er is the 
fact that when an epidemic is especially severe in a locali- 
ty, it is almost certain to recrudesce the following year. 
We Avere therefore not surprised to note, in the report 
aboA^e cited (page 451), that the disease under discussion 
re-appeared in Dahomey in 1906. 

The first case erupted at Ouidah, April 12. The patient, 



206 HISTORY OF YELLOW FEVER. 

the wife of a German subject, died a few days after being- 
attacked. 

Between April 23 and May 3, 4 deaths were reported 
from Togo. 

May 5, 2 cases were obseryed in Grand- Popo. One of the 
yictims died. The patient recoyering was the husband of 
the German lady, mentioned aboye. 

On May 10, a fatal case was obseryed at Ouidah. This 
was followed, on May 20, by another case, which termin- 
ated fatally on June 3. 

May 21. Cotonou, until then immune, became infected. 
One case, followed bj^ death on the 29th, is recorded. 

May 29. One case at Grand-Popo. Eecoyered. 

June 5. One case, a nun, at Ouidah. Died June 8. An- 
other case at Ouidah on the 5th, imported from Toffo, 
where unconfirmed cases had been obseryed. Eecoyered. 

June 16. One death at Ouidah. 

June 23. One case at Ouidah, followed by death on 
25th. 

This was the last case of the epidemic. There were alto- 
gether 15 cases, with 12 deaths, distributed as follows : 

Locality. Cases. Deaths. 

Cottonou 1 1 

Grand-Popo 3 1 

Ouidah 7 fi 

Togo 4 4 

Total .... 15 12 

The origin of the epidemic is unknown. 

1907. 

In January, 1907,^^ Dahomey was still under the ban of 
quarantine, yellow feyer haying made its appearance at 
Grand Popo in the beginning of the year. Up to the time 
of the closing of this report, no details could be obtained. 

** Kermorgant : Annales d'Hygiene et de Medecine Coloniales, 
1907, vol. 10, p. 299. 



EGYPT. 

Description. 

Egypt is a country in the northeastern part of Africa, 
governed by a viceroy (khedive), who pays tribute to the 
Sultan of Turkey, but is otherwise independent. Egypt 
is bounded on the north by the Mediterranean Sea, on the 
east by Arabia and the Ked Sea, on the south by Abyssinia 
and other unimportant countries; and on Ihe west by tlie 
Desert of Sahara. Capital, Cairo. 

"THE PLAGUE SPOT OF THE WOELD." 

According to the opinion of medical writers, we have to 
accept Egypt as the country whence pestiknce most fre- 
quently originated and extended itself. This is why that 
ancient land has been christ'med "The Plague Spot of the 
World." From time immemorial, the terrible Oriental 
Plague and epidemic cholera were, in almost ':very in- 
stance, first observed in Egypt before they began their 
journey of death and desolation. Cairo and the villages 
of the Delta were generally attacked first; thence the 
whole civilized world was infected. 

HOW MEHEMET ALT KEDEEMED EGYPT. 

A little historical causerie, to relieve the mind from the 
array of cold-blooded statistics which are part and parcel 
of a work of this kind, will be found refreshing and inter- 
esting. 

The Egyptians are the earliest people known to us as a 
nation. When Abraham entered the Delta from Canaan, 
they had long been enjoying the advantages of a settled 
government. They had built cities, invented hieroglyphic 
signs, and improved them into syllabic writing, and almost 
into an alphabet. They had invented recordS; and wrote 
the names of their rulers and their heroic actions on the 
massive temples which they raised. More than 2000 years 
B. C, the Egyptians had duodecimal as well as decimal 
numbers, and weights and measures. The masonry of the 



208 HISTORY OF YELLOW FEVER. 

passages in the Great Pyramid has not been surpassed at 
any age. In mechanical arts, the carpentei-, boai-builder, 
potter, leather-cutter, glass-blower and others, are often 
represented on their ancient monuments. They were also 
adepts in other arts too numerous to mention. The social 
and domestic life of the ancient Egyptians is depicted on 
the walls of their temples and tombs. 

Cairo, the capital of Modern Egypt, is situated on the 
right bank of the Xile, 12 miles above the apex of its delta, 
and 150 miles by rail from Alexandria, and has a popula- 
tion of 374,838 souls. The character of the town is still 
mainly Arabic, though in modern times the European 
style of architecture land ether matters has become more 
and more prevalent. The city is partly surrounded by a 
fortified wall, and it is intersected by seven or eight great 
streets, from Avhich runs a labyrinth of narrow crooked 
streets and lanes. There are several large squares, or 
places, the principal being the Ezbekiyeh^ To the south- 
east of the town is a citadel, on the last spur of the Mo- 
kattam Hills, overlooking the city. It contains the fine 
mosque of Mehemet Ali, a well 270 feet deep called 
•Joseph's Well, cut in the rock, the palace of the Viceroy, 
and other things of interest to tourists. There are up- 
wards of 100 mosques. The finest is that of Sultan Has- 
san. There are also some forty Christian churches, Jew- 
ish synagogues and other denominations. The tombs in 
the burying-grounds outside of the city also deserve men- 
tion, especially those known as the tombs of the Caliphs. 
The trade of Cairo is large, and the bazaars and markets 
are numerous. Of these the Khan el Khalilivin the north- 
east of the town, consists of a series of covered streets and 
courts in which all kinds of eastern merchandise are dis- 
played in open stalls. Cairo has railway communication 
Avith Alexandria, Suez, and Siout. 

Before the Avatering and sweeping of the streets of 



EGYPT. 209 

Cairo Avas introduced by the Vicevoy, Meliemet Ali,^^ in 
the beginning of the last century, thej were full of filth. 
A canal running through the city received all kinds of 
refuse, and Avas much neglected; its borders had always 
been considered as most unliealthV;, and most frequented 
by. the plague. MoreoA^er, Cairo AA^as surrounded AAath an 
almost comi3lete circle of hills, one hundred and fifty to 
three hundred feet in height^ and aa here these ceased, by a 
projection of the Mokattam mountains. Thus purifying 
AA'inds Avere cut off from the city. The disease alAA^ays ap- 
peared after the receding AA^aters of the Nile had left much 
animal and A^egetable matter decaying, producing nias- 
mata under the combined influence and moisture, and 
after raging scA^eral months, disappeared AA^th the nucta 
(a heaA^y dcAv) and the scorching rays of the June sun. 

Mehemet Ali gaA^e orders to clean the 'city, and to Avater 
and SAveep the streets cA^ery morning, but the state of 
health did not materially improve. It had already been 

"' Mehemet Ali, Viceroy of Egypt, born at Kavala, in Mace- 
donia, in 1769. He entered the Turkish army, and served 
in Egypt against the French; rose rapidly in military 
and political importance; became Pasha of Cairo, Alex- 
andria, and subsequently of all Egypt. In 1811 he mas- 
sacred the Mamelukes to the number of 470 in Cairo, 
and about 1200 over the country. He then commenced, 
by the orders of the Porte, a war of six years' duration 
against the AVahabees of Arabia, which was brought to 
a successful conclusion by his son Ibrahim, and secured 
him the possession of Hejaz, Ibrahim also aided in 
bringing a large part of the Soudan under Egyptian rule. 
By means of a vigorous domestic policy Mehemet re- 
duced the finances to order; organized an army and a 
navy; stimulated agriculture, and encouraged manufac- 
tures. In 1824-27 he assisted the Sultan in endeavoring 
to reduce the Morea, which led to the destruction of his 
fleet by the allied European powers at Navarino (1827). 
Subsequently he turned his arms against the Sultan, and 
in his efforts to secure dominion over Syria by armed 
invasion, he was so far successful that the European 
powers had to interfere and compel him to sign a treaty 
in 1839, which gave him the hereditary pashalic of Egypt 
in lieu of Syria, Candia, and Hejaz, This remarkable 
personage died in 1849 at the age of eighty. 



210 HISTORY OF YELLOW FEVER. 

remarked by physicians of the army, at the time of the 
French-Egyptian expedition, that the encircled position 
of the city, combined with other nnfaforablt circum- 
stances, must be very unhealthy. Advisers of Mehemet 
Ali repeated the remark, and the Viceroy; who was a 
tyrant, but seldom shrinking from the extent of an enter- 
prise, took the bold resolution of carrying down a large 
portion of the hill into the fields, which, after having suf- 
ficiently elevated, he intended to water artificially and to 
convert into beautiful gardens. As once the Pharaohs 
dragged thousands of men to the erection of temples and 
pyramids, so Mehemet Ali forced thousands of fellahs 
(Egyptian peasants) to execute his plans. Many died un- 
der the excessive labor, but the ranks were filled by others, 
and the work itself was always advancing. Thus a long 
chain of hills was carried down, and miasmatic marshes 
converted into charming olive and fruit gardens. And 
as the work progressed the health of Cairo improved. 

The disease, no longer brought from Egypt to other 
parts of the Turkish Empire, disappeared. Mehemet Ali 
has proved what can be done, even under the most unfavor- 
able circumstances, by his grand and energetic measures, 
in improving the health of one city; and by thus destroy- 
ing the germ of this most destructive of all diseases, he has 
unconsciously saved the lives of millions.^^ 

ALLEGED YELLOW FEVEE YEAE. 

1800. 

SUMMAEY OF EPIDEMIC. 

With the exception of the alleged epidemic depicted by 
Dr. Larrey,^^ we fail to find anywhere any menticn of yel- 
low fever in Egypt. We have ransacked the works of 
ancient, medieval and modern writers on epidemiology, 
but only find the solitary instance narrated by Baron 
Larrey. In our opinion, this was not yellow lever, for 

*«Dowell: Yellow Fever and Malarial Diseases (1876), p. 25. 
«^ Larrey: Memoirs of Military Surgery and Campaigns of the 
French Armies, etc., (Hall's Translation), 1814, p. 230. 



EGYPT. ^ I 1 

that disease could not originate in Egypt, and nowhere in 
Larrey's account do we find any mention of importation. 
We would have passed this account by without giving it 
any attention had the author been an irresponsible or less 
distinguished personage, but Baron Larrey was one of the 
most noted surgeons of his day, holding the post of Sur- 
geon-in-Chief of the Army of Napoleon in his foolhardy 
invasion of Egypt, and was the author of notable surgical 
works His post naturally afforded him abundant oppor- 
tunities for practical study and a careful perusal of his 
writings shows that he studiously availed himself of his 
astute powers of observation and deduction by collecting 
numberless important and interesting facts. 

Dr. Larrey was a close and intelligent observei, and his 
descriptions of the several phases of the disease he had to 
deal with, even if antagonistic to the tenets of this en- 
lightened -age, are so replete with interesting d^-^ail, that 
we will quote at length from his views on the cause, path- 
ology and treatment of the maladv which decimated the 
army of the great Napoleon in the campaigns which proved 
so disastrous to the French arms. 

^^The fatal consequences which tcok place in a great 
number of our men who were wounded in the battle of 
Heliopolis," observes Dr. Larrey, ''and at the siege of 
Cairo in 1800, led our soldiers to believe that the balls of 
our enemy were poisoned. It was not difiicult to unde- 
ceive them; but not so easily could we arrest the progress 
of the disease." 

This eminent authority further asserts that the malady 
presented all the symptoms of the yellow fever observed in 
America during the campaigns of the French armies in 
the West Indies and which^ according to the report of Dr. 
Gilbert, his former colleague, who was physician-general 
of the army of St. Domingo, reappeared among the French 
troops during the expedition to that island in the last de- 
'cade of the eighteenth century. 

A peculiarity noted by Dr Larrey in Egypt was that the 
fever attacked none but the wounded, and more particu- 
larly those who had been injured in the articulations, or 
had fractured bones, with injuries of the nerves, of the 
head, of the abdomen or thorax. The disease appeared 



212 HISTORY OF YELLOW FEVER. 

about the 5tli of April, 1800. and disappeared aloiit the 
last of May. Dr. Larrey gives the folloAving details of 
the principal symptoms which the malady presented: 

"The wounded had scarcely received the lirst assistance, 
or submitted to an operation, when they fell into a state 
of faintness and anxiety; rigors were felt over <he Avhole 
body, and especially in the inferior extremities. At the 
first attack the eyes were heavy, the conjunctiva yellow, 
tlie visage copper colored, and the puJse slow and con- 
tracted. The patient felt pain in his right hypocliondrium, 
and his wounds Avere dry, or discharged a red serum. 
These symptoms were followed by inuch general heat, 
burning thirst, violent i^ains of the intestines and head, 
somelimes accompanied by delirium, frenzy, oppression, 
and frequent sighing.'' 

Speaking of the causes of the epidemic, Di. Larrey 
says : 

"I think that many causes concurred in i^roducing the 
yellow fever among our wounded The first Avas, crowd- 
ing the hospitals; as insurmountable difficulties opposed 
the formation of other establishments, we could not reme- 
dy this. Besides, the wounded occupied the Avards on the 
ground floor, the moisture of which increased the disease., 
It did not appear in the elevated and airy wards to any 
considerable extent. MoreoA^r. the troops, of which these 
Avounded were formerly a part, Avere encamped on the west 
of Cairo, between this city and Boulaq, in a situation low 
and moist, more especially after the waters of the Nile 
had receded from a place where they had undergone de- 
comi30sition, by remaining long exposed to the heat. The 
sudden transition from the scorching heat of the daA^ to 
the moisture of the night, to which the troops AA^ere ex- 
posed, necessarily tended to Aveaken them and p^^edispose 
to the disease. The atmosphere, in the season of khamsyn, 
is hot and moist, and consequently injurious to health. At 
tliis time also the plague prevails, and we might say that 
the yellow fever, from the similarity of its effects, and its 
speedy termination, bears some analogy to this scourge. 

"To the causes already enumerated, we might add the 
excessiA^e fatigue of the soldiers, the deficiency of good all- 



EGYPT. 2 1 3 

inent: of cooling remedies and aeid drinl^s, and tlie want 
of cloaks to cover them during the night." 

The surrender of Cairo ha\dng re-established communi- 
cation with the outside world, the French were enabled 
to establish ncAV hospitals, and to procure good aliment, 
medicines, linen and bed furniture. Tiiey removed a great 
part of their sick to more sanitary quarters. These cir- 
cumstances, and the return of the w-ind to the north, in 
the judgment of Dr. Larre^^, soon caused the d'sease to 
disapi^ear. 

The following mode of treatment followed by Dr. Larrey 
is certainly unique : 

"When yellow fever was acute, and presented ihe symp- 
toms of an inflammatory fever with jaundice, spasmodic 
vomiting, delirium, etc., dry scarifications of the liga- 
mentum nuchae and on the hypochondria, jjroduced very 
good effects, or in lieu of them, a small quantity of blood 
was taken from the arm. But copious blood letting was 
fatal, and it was even necessary to use the greatest cir- 
cumspection in the first detraction of blood. Nitrated 
tamarind water, sweetened with honey or sugar, or a few 
glasses of nitrated and anodyne camphorated emulsions 
taken at night, relieved thirst and moderated intestinal ir- 
ritation. If, in conjunction with these remedies, ' the 
bowels were moved in the first twenty four hour,s, we had 
hopes. We then continued the use of cooling medicines, of 
anodynes, of antispasmodics^ followed by laxatives of 
neutral salts, and calomel, tonics, and antiseptics by de- 
grees. Emetics would have been pernicious. But if in an 
opposition to these means the symptoms increased, the 
disease terminated fatally. When, on the contrary, the 
disease commenced with ataxic symptoms, such as pros- 
tration of strength, faintness, chillmess, blackish tinge of 
the tongue, and constipation, emetics in gruel removed the 
spasm, re-established the powers of the stomach, and 
facilitated the actions of the tonics and antiseptics; w^e 
then exhibited these latter Avith some success; chJnchona, 
camphor combined w^ith opium, Hoffmann's mineral 
liquor, and bitters in suitable doses. The cortex appeared 
to be less effectual than good wine brewed with sweetened 



214 HISTORY OF YELLOW FiilVER. 

lemonade, and to which a portion of ether was af lerwards 
added 

^'Coffee was to us highly useful; and we employed it to 
great advantage when the disease? had passed the second 
stage, when suppuration was re-established in the wounds, 
and the patient was about to recover. It expedited in these 
cases the return of the vital powers and gave nourishment. 
These means were persevered in, and their use modified at 
every stage of the disease. Spurge-laurel and mustard, 
pounded with vinegar, and applied to the hypochondria or 
back, co-operated greatly with these remedies. In this dis- 
ease, I remarked the injurious effects of caiitharides; 
therefore, I seldom used them. s 

''Wounds complicated with bilious fevers, were dressed 
according to the particular indict^ tion. They were 
sprinkled with camphor and bark^ when they were threat- 
ened with gangrene, and we used tlie vegetable acids, 
chiefly of the lemon, which is abundant in this country. 
If they assumed the symptoms of putridity, I also ordered 
lotions of vinegar strongly camphorated, to be used on 
the head and over the surface of the body. 

''Those who survived the yellow fe\^er, had a tedious 
convalescence; some even had relapses and died in a few 
days. The yellow fever did not sjjare the Turks who were 
wounded. Being requested by the commander-in-chief, 
after the surrender of Cairo, to afford them assistance, I 
had them all collected in a mosque, to dress them more 
conveniently. 

"A large proportion of the Turks who were attacked by 
this disease fell victims to it. We maj attribute these un- 
fortunate results to the bad treatment to which they were 
subjected, and to the privations v;hich they underwent 
during the siege." 

The following remarks on the pathology of the disease 
are interesting : 

"The effects of this disease appeared on optuing the 
dead bodies. We found a reddish sernm in the cavities of 
the chest and abdomen, inflation and '.nflammation of the 
intestines; obstruction of the liver and spleen; the gall 
bladder contained but little bile, and this was thick and 
of a black color; gangrenous affections were seen in differ- 



EGYPT. 2 1 5 

ent parts of the body, and especially Id the adipose sub- 
stance. The organs of the thorax presented nothing re- 
markable ; all the soft parts of the wounded limb were 
gangrenous, and emitted a nauseous and fetid odor. Two 
hundred and sixty out of six hundred, who were wounded 
at the seige of Cairo and the taking of Boulaq, died with 
a complication of this disease." 

An exhaustive review of Ur. Larrey's work is given in 
the Eduihiirg Medical Revleiv^^ and the epidemic de- 
scribed by him is commented upon by Gamgee in his 
treatise on yelloAV fever. ^^ We find no mention of the in- 
cident in other works on epidemiolcgv- 

A curious passage occurs in Dr. Larrey's book, which 
throws some light upon the peculiar beliefs of the time. It 
seems that before Napoleon's army left Sja-ia, a great 
number of the soldiers were attacked by the plague. ''It 
seldom attacked the wounded men," observes th: doctor, 
"and scarcely an instance occurred of anyone being affect- 
ed by it whilst the vrounds were in a state of suppuration, 
though many were infected as soon as the wounds were 
healed." 

According to the Edinhurg Medical Journal of 1804 
(page 217), the above observation was made by all wT-iters 
on the plague, and it was currently reported at the time 
that Europeans who were established in Egypt and Syria 
guarded themselves from this pest, or at least seemed to be 
less disposed to be affected by it, by. means of habitual ill- 
ness. 

Whether the sporadic outbreak depicted by Baron Lar- 
rey was yellow fever or not, we cannot say, as no corrobo- 
rative evidence can be found to sustain the eminent 
Frenchman's views; but if the disease was yellow fever, it 
certainly could not have sprung from the soil or from 
climatic conditions, but must have been iiaported by the 
French war vessels, either from Spain, where the disease 
was widespread in 1800, or from Mexico or the West In- 
dies, where yellow fever was ever present in the past. 
From the West Indies or Mexico to Egypt is a long jour- 

^n804, p. 213. 

*** Gamgee: Yellow Fever a Nautical Diseases, 1879, p. 105. 



?16 HISTORY OF YELLOW FEVER. 

iiej, to be sure, but Stegomyia have been known to live for 
months in the holds of vessels and to be just as active in 
inoculating the germs of yellow fever on being liberated 
as if thev were fresh from the nidus of infection. 



FERNANDO-PO. 

Description. 

Fernando-Po forms one of a group of four islands in 
the Bight of Biaffra, West Africa, 20 riiles off the coast of 
Guinea. The other islands of this group are Annobon, 
Princess Island and St. Thomas. The two last named be- 
long to England ; the others to Spain. Fernando Po and 
Annobon were discovered by the Portugese navigator, 
Fernao de Poo, in 1496, and annexed to the crown of Por- 
tugal. The islands were colonized bv that country in 
1592, but proving an unprofitable venture, were ceded to 
Spain in 1777. In 1827, the islands had become merely a 
nominal Spanish possession. English intrigue having al- 
most absorbed them; but Spain suddenl}^ woke up to the 
state of things and filed a vigorous protest against the 
machinations of the English court. The British Govern- 
men, balked in its scheme to surreptitiously annex the 
islands, offered to purchase them for 1300 000. This 
proposition, after being considered anc. debated for nearly 
fourteen years, was finally rejected by the Corte: in 1841. 
England reluctantly disgorged the prize, recalled its gov- 
ernor-general and the Spanish flag h?s been floating over 
the islands to this day. But John Bull, who^e land- 
grabbing policy has won for him a niche in the hall of 
diplomatic intrigue, no doubt still looks with covetous 
eyes upon those two. islets and we may wake up one of these 
fine mornings and read of England being sole owner and 
dictator of this quartette of islands nestling like huge 
rocks deep in the Bight of Biaffra. 

The population of Fernando Po is about 20,000, being 
a mixture of negroes, Portugese and other Europeans. 
The capital is Clarence Town. 

YELLOW FEVER YEAES. 

1792; 1812; 1829; 1839; 1857: 1860; 18'i]2; 1864; 1866; 
1868; 1869. 



218 HISTORY OF YELLOW FEVER. 

SUMMAKY OF EPIDEMICS. 

1792. 

Tli3 first recorded invasion of velloAV fever at Fernando 
Po took place in 1792. Xo details are given by our 
authoritv.^^ 

1812. 

In tlie beginning of the vear 1812, the disease was im- 
ported by three vessels, the Carkladj the Isabel and the 
Ferla. We have been unable, beyond ascertaining the 
names of the vessels, to cull any data concerning this out- 
break, as otir authority^^ has unfortunately neglected to 
touch upon this important detail. The ferer was either 
imported from the West Indies, as the names of the ves- 
sels suggest that they sailed under the Si)anish flag and 
the commercial relations between Fernando Po and the 
West Indies were freqtient and extensive ; or, which is no 
doubt still more probable, these vessels came frr»m Spain 
or Portugal, stopped on their way to Fernauvlo Po at 
Si3rra Leone, and were infected while at anchor in one of 
the harbors of that notorious foctis of yellow fever propa- 
gation. 

Xo mention is made in the accotmt of this outbreak of 
the cases of mortality at the island, but the statement is 
given that the total mortality on board the three vessels 
aggregated 12, inchtding the surgeon-in-chief of the Perla. 

In this connection, it is to be deplored that such an 
authority as Dr. Eey, who writes so minutely and inter- 
estingly of the history, climate, topography and nattiral 
resources of Fernando Po, did not take the trouble to give 
the details of this ''epidemic" — as he terms it - and thus 
add additional historical value to his v>'ork. But he little 
dreamed that this information would be of immense value 
to the compiler of this history and overlooked the impor- 
tant function. This is only one of the millioi] illiistrations 
of that trite Americanism, "every little bit helps/- 

** Berenger-Feraud, loc. cit., p. 60. 

"Rey: Archives de Medecine Navale, Paris, 1878, vol. 29, 
p. 407. 



FERNANDO-PO. 219 

1829. 

After a lull of fifteen years, yellow fever again made its 
appearance at Fernando Po. This time, the infection is 
indisputably traced to Sierra Leone. The facts are as 
follows :^^ 

At the inception of the epidemic of yellow fever which 
decimated Sierra Leone in 1829, the British ship Eden 
was anchored in the roads, off Freetown, and, as was the 
usual custom in those days, her officeis were occasionally 
on shore. On the 3d of May, a man, who two days previ- 
ously had come aboard the Eden from Freetown, was 
taken ill with yellow fever and died on the Tth. On 
May 5, two days after this man had been taken ill, a mid- 
shipman, Avho had been on board a detained vessel of which 
he had charge, returned on board the Eden. He had been 
taken ill on April 29th and died the day following his re- 
moval to the Eden. On May 12, some other cases occurred 
among the ship's crew, and on the 201h of May the Eden 
left for Fernando Po. She arrived at her destination on 
the lltli of June, having lost during this period 25 officers 
and men. She was thoroughly cleaned, fumigated, and 
whitewashed at Fernando Po, and then, re-embarking her 
convalescents, sailed for Princess Island on the 9th of 
July. After the departure oi the Eden, the disease broke 
out at Fernando Po, where it prevailed with great severity. 
The mortality was not very great. 

During the voyage from Fernando Po to Princess 
Island, the fever reappeared aboard the Eden, and the mor- 
tality was considerable. The fever continued to rage till 
August, and the Eden lost, between the months of May 
and December, 110 persons out of a complement iff 160. 

At the same time that the Eden carried the disease to 
Fernando Po, the Champion sailed from Sierra Leone with 
several bad cases of fever on board and arrived at Clarence 
Town three days after the Eden. As on board the Eden, 
the fever which was ravaging the Champion was of a most 
malignant type and the landing of her sick at the little 

^-Bryson: Report on the Climate and Principal Diseases of 
the African Stations, p. 39. 



220 HISTORY OF YELLOW FEVER. 

town added fuel to the dormant fires of pestilence already 
kindled by the Eden. 

According to Bryson,^^ from the time it was first occu- 
pied by Europeans, Fernando Po proved a perpetual hot- 
bed of disease. Most of the people who were located at Clar- 
ence Cove during the years 1827 and 1828, were attacked 
with fever or ulcer, and cut off in the course of a few 
months after their arrival. But as the medical returns 
only commence subsequently to the f.rrival of the Eden 
and Champion, the accounts respecting the fevers which 
prevailed previoush^, can only be gleaned from other 
sources, which, although sufficiently authentic as to their 
fatality, do not give the information requisite to follow 
them out in full detail. That it had acquired the charac- 
ter of being a most unhealthy locality, the number of medi- 
cal officers who accompanied the marines and mechanics 
sent out in the Champion, sufficiently attests; and it is a 
melanchol}^ reflection that only two out of the three 
reached the anchorage in time to have their bones deposited 
in that desolate grave-yard. 

1839. 

Yellovv' fever was again brought to I'ernando-Po in 
1839 and was quite severe.®* 

1857. 

In 1857, yellow fever again invaded Fernando Po.®^ 

1860. 

A ship from the West Indies is incriminated in the in- 
fection of Fernando-Po in 1860. The epidemic was quite 



^^Bryson: Loc. cit., p. 49. 

®*Bryson: Loc. cit, p. .. 

^Huard: Theses de Montpellier, 1868. 

"^'Yglesias y Pardo (Rerreo), 1874, p. 12. 



FERNANDO-PO. 221 

1862. 

In the early days of July, 1862^ yellow fever broke out 
at Feruando-Po amongst the Spanish population. The 
disease was first observed in one of two convict hulks in 
Clarence Ba}- and spread rapidly to the convicts and sail- 
ors in the other hulk, whence it attacked the soldiers com- 
posing the small garrison and the mechanics on shore. 
In a very short time, 76, out of 200 composing tlie entire 
purely Spanish population, were carried away by the dis- 
ease. A remarkable phase of this epidemic is that it was 
confined exclusively to the Spaniards of unmixed blood 
and did not attack the colored Cuban settlers (einanci- 
pados), although the latter nursed the sick and visited 
freely all the foci of infection. This proves conclusively 
that the disease was the genuine West Indian yellow 
fever, for the criiancipados, who evidently had experi- 
enced an attack in their own country, escaped unscathed. 

The source of importation is dispufed. Some authori- 
ties claim that the inter-colonial mail steamer Metriever 
brought the disease from Bonny, Africa, while Bourru, 
Berenger-Feraud and Ygiesias y Pardo^'^ assert that the 
English ship Ferrol, which left Havana on June 10, 1862, 
with 200 emancipados^ should be looked upon as the nidus 
of infection. 

The French ship La Ze?ce was infected at Fernando-Po 
in 1862 and brought the disease to Grand Bassam (q. v.). 

1864. 

Another outbreak of yellow fever occurred at Fernando- 
Po in 1861. No details are given. ^^ 

1806. 

The epidemic of 1866 continues the chain of importa- 
tion. 

On August 2, 1866, the ship Rosa del Ttirla, having on 

®^ Bourru: Geographie des Epidemies de Fievre Jaune, p. 7; 
Berenger-Feraud, p. 139; Ygiesias y Pardo, loc. cit., p. 12. 
^^Berenger-Feraud, loc. cit., p. 141. 



22 S HISTORY OF YELLOW FEVER. 

board about 200 convicts, sailed from Havana for Fernan- 
do-Po, which was then a penal settlement, arriving at her 
destination on October 3 of the same year. During the 
two months the vessel took to make the trip, yellow fever 
prevailed to a more or less extent among her crew and 
living cargo, but this did not deter those in command of 
the vessel from landing the 200 convicts on the island. A 
disastrous epidemic broke out shortly aftervrards, which 
caused much mortality on the island and lasted until the 
end of November. 

Again we find occasion to criticize the excellent and 
astute Dr. Eey,^^ to whom we are indebted for the above 
narration of the epidemic of 1866, The genial doctor de- 
cries the attempts made by certain chroniclers of the 
period to hide the true nature of this epidemic under the 
name of bilious pernicious fever, but overlooks the most 
important information, the statistics ot the outbreak. He 
informs us that the Perle lost ten of her crew, but is mute 
as to what happened to the unfortunate inhabitants of the 
island. 

18G8. 

On September 24, 1868, the ship General Alva arrived 
at Fernando-Po from Havana.^^ A few days after the 
vessel'^: arrival, yellow fever broke out on the island, but 
was not very severe. 

1869. 

On May 22, 1869, the transport San Fraiielsco de Borja 
arrived at Fernando-Po with 250 men deported from Ha- 
vana. ^*^'^ Yellow fever prevailed to some extent on board 
the vessel, but no mention is made of the disease having 
reached shore. 

*Rey: Archives de Medecine Navale, Paris, 1878, vol. 29, 
p. 407. 

®'Bourru: Geographie des Epidemics de Fievre Jaune (Bor- 
deaux, 1883), p. 7. 
^""Penard and Boye: Annales d'Hygiene et de Medecine Col- 
oniales, 1904, vol. 7, p. 509. 



FRENCH GUINEA. 

Description. 

French Guinea, as the name implios, is a French col- 
onial possession on the west coast of Africa, bounded on 
the north hj Senegambia, on the east by the Ivory Coast, 
on the south by Liberia and feierra Leone and on the Avest 
by the Atlantic Ocean. Capital. Conakry, situated on the 
Tombo Peninsula. Conakry is of recent origin. It was 
founded in 1889 and has at present a population of about 
12,000, principally natives. The European population is 
about 350, but is hardly 275 during the sickly season. 

YELLOW FEYEK YEAR. 

1901. 

SUMMARY. 

French Guinea was in imminent danoer of being iuA^aded 
by yellow fever during the epidemics at Senegal in 1900 
and 1901 and at Grand Bassam in 1902 and 1903 ; but save 
for a single case, observed December 21, 1901 at Conakry, 
the territory seems to have been exempt from tljc disease. 
It is not known definitely whether or not Sfegomyia 
Calopus breed at Conakry, as no special observations 
have been made in that direction, but the fact that this 
solitary instance of the appearance of yellow fever in the 
locality did not cause a general eruption, may be taken as 
a tentative proof of the non-existence of the insect there. 

The case mentioned above was piobably iinijorled from 
Senep:al. 



GAMBIA. 

Descripticn. 

Giii.it,ia is a British colony of T\>stern Africr, consist- 
iMg (,r thc3 island of St. Mary? the town of B-itLiirst (the 
capita] ) and other minor dependencies. Artil; i)9 square 
Miles Poptilation about 15,000. 

YELLOW FEVER YEAES. 

17(33; ITIU; 1766; 1768; 1769; 1778; 1825; 1S2S; 1837; 
1859; 1860; 1865; 1866; 1878; 1881; 1900. 

SUMMAEY OF EPIDEMICS. 

17C3. 

The first outbreak of yellow fever in Gambia (1763) is 
coincident Avith the first appearance of tie di-ease in 
Sierra Leone and was no doubt imported fr jm tliat colony, 
which since then has played sucli a notorious role in radi- 
ating the scourge to the otherwise healthy stations of the 
West African coast and the near-by insular coF.nies. In 
nearly every instance, the chain of importation has been 
the same: Sierra Leone, infected by ships from the West 
Indies or South America, lias contaminated Gambia; 
Gambia has sent the disease to Senegal, and the latter 
colony has. propagated the pestilence to other African set- 
tlements. 

It is unfortunate that no detailed accounts exist of these 
first outbreaks on the African coast. Otir authority^ is 
deplorably uncommunicative on this score. 

1761. 

Yellow fever again invaded Gambia in 1761. Only a 
mere mention of the fact is made by our source of in- 
formation. - 

' Berenger-Feraud, p. 53. 
Mbid., p. 53. 



GAMBIA. 225 

IToo. 

Anotker eruption in Gambia.^ No details cbtainable. 

1TG8. 

The outbreak of 1768 furnishes us with the first intelli- 
gent account of yellow fever in Gambia. According to 
Lind,^ in August, 1768, the British ship Merlin^ while in 
the Gambia Eiver, lost several of her crew from yellow 
fever. Lind would have us believe that the fever was 
caused by effluvia rising from freshl}^ cut timber, but as 
yellow fever was then reigning at Bathurst, the capital of 
Gambia, Avhere the ilferZi^i stopped on its voyage up the 
Gambia, the source of infection is clearly established. 
How the fever got to Bathurst, is left to conjecture. 

17G9. 

Yellow fever prevailed in Gambia in July. 1769. In the 
month of August following, the British warships Weasel 
and Hound were contaminated at Bathurst and Ijst many 
of their crews. The disease is said to have been severe.^ 

1778. 

In 1778, yellow fever w-as almost general on the western 
coast of Africa.^ The memorable epidemic of Senegal, 
about which so much has been written, occurred that year. 
Gambia was infected by Sierra Leone and sufff^red con- 
siderablv. 

1825. 

A lull of nearly fifty years took place before yellow fever 
again manifested itself in Gambia. Although the disease 
prevailed in Sierra Leone in 1815, 1816 and 1823, it does 
not appear to have reached Gambia ; but, in 1825, it was no 

8 Ibid., p. 54; Schotte. 

■•Lind: Diseases of Hot Climates, vol. 1, p. 250. 

^ Berenger-Feraud, p. 55. 

' Berenger-Feraud, p. 56; Schotte. 



226 HISTORY OF YELLOW FEVER. 

doubt imported from Sierra Leone. The diseasi^ caused 
much mortality at Bathurst and the surrounding country, 
three-fourths of the cases terminating fatally.'^ Bryson 
(page 33) informs us that a detachment of one hundred 
and eight men landed at Gambia in 1825; in the course 
of four months seventy-four died of fever, and thirteen 
of other diseases, leaving only twenty-one alive 

1826. 

The fever re-appeared in Gambia in 1826 and was very 
severe. xA.s in 1825, the majority of those attacked died.^ 

1828. 

The epidemic of 1828 ravaged the whole African coast 
from Benin to Gambia.^ It was not severe in Gambia. 

1837. 

After an absence of nearly ten year*;', yePow fever made 
its appearance with renewed virulence in Gambia in 1837. 
The epidemic was attended with a high death-rate. ^^ 

1859. 

Yellow fever prevailed at McCarthy Island, in the 
Gambia Kiver, in 1859, according to Berenser-Feraud 
(page 136). 

ISGO. 

Yellow fever re-appeared in Gambia in 1860. The dis- 
ease does not seem to have manifested itself on ihe main- 
land, but prevailed on McCarthy Island,^^ in the Gambia 
Eiver, 127 miles from its mouth, inhabited iDrincipally b}^ 
liberated slaves. 

' Second Report on Quarantine (1852), p. 288. 

^ Second Report on Quarantine, p. 288. 

® Berenger-Feraud, p. 105. 
^° Berenger-Feraud, p. 105,. 
^^ Berenger-Feraud, p. 136. 



CAMBIA 227 

1885. 

Another outbreak of yellow fever caused much mortality 
in Gambia in 1865. Our author! ty^^ does not furnish any 
details. 

18o6. 

Yellow fever reigned with much virulence at Bathurst 
in 186(3. One-half of the European population perished.^^ 
No official account of this epidemic exists, as the facts 
were suppressed by the British Government, for commer- 
cial reasons, and only reached the public through a private 
letter published in the London Times. An investigation 
was demanded by the public, but dilatory measures by the 
authorities soon caused the exjisode to be forgotten. 

1872. 

In 1872 yellow fever was quite severe at Bathurst. Out 
of a white population of 31, there were 13 deaths.^^ 

1878. 

The yellow fever epidemic of 1878 may truly be called 
a pandemic. A reference to our chrorological tables will 
show that it prevailed on both sides of the Atlantic, on the 
Pacific coast and, for the first and last time in the history 
of the disease, a case was imported to London and died. 

The official records of Gambia are silent regarding the 
prevalence of yellow fever in that colony in 1878, but 
Berenger-Feraud^^ claims that the facts were suppressed 
and that the disease was present that year, in a mild form. 
The noted author takes issue with Lejemble, who tries to 
prove that the fever could not have been in Gambia in 
1878, because that country maintained a strict quarantine 
against Senegal and that the official reports do not men- 
tion yellow fever at all. Berenger-Feraud cites :n refuta- 

^ Berenger-Feraud, p. 141. 
^^ London Lancet (New York), 1867, p. 60. 
"Lejemble: Theses de Paris, 1882, No. li, p. 22. 
^ Berenger-Feraud, p. 154. 



228 HISTORY OF YELLOW FEVER. 

tion of this assertion the fact that in 1872 yellow fever 
raged fiercely in Sierra Leone and Garabia, yet the of&cial 
records of the colony are a perfect blank regarding this 
outbreak. We can yerily concur with this eminent chron- 
icler, for, by referring to our own account of the epidemic 
in Gambia in 1866, it will be seen that the authorities sup- 
pressed the fact that a virulent eruption of yellow fever 
was causing great mortality at Bathurst and the sur- 
rounding country and it was only when the London Times' 
received private information concerning the state of affairs 
and gave the matter publicity, that an ''investigation'* was 
ordered by the British Government. ^^ 

1881. 

In June, 1881, yellow fever was present in Sierz-a Leone ; 
in August, it invaded Gambia ^" Here we find the same 
old story of importation from Sierra Leone. The outbreak 
does not appear to have been severe. 

1900. 

The year 1900 furnishes the last recorded appearance 
of yellow fever in Gambia. A sporadic otitbreak occurred 
at Bathurst, but the disease did not gain a very disastrous 
footing, as the white settlers fied at the first signs of the 
fever, seeking refuge on board the ca^^go-boats bound for 
European ports.^^ As usual, no official records of the out- 
break could be obtained. 

^« London Lancet (New York edition), 1867, p. 60. 

" Berenger-Feraiid, p. 190. 

^« U. S. Public Health Reports, 1900, vol. 15, p. 2025. 



GOLD COAST. 

Description. 

Gold Coast is a British crown-colony in West Africa, 
betAveen the Slave Coast and the Ivory Coast, and com- 
prises that part of the coast of Guinea which extends 
from 50° W. to 20° E. longitude, stretching inland to an 
average distance of fifty miles The climite is very un- 
healthy. The chief forts and settlements are Cape Coast 
Castle, Elmina, Accra, Axim, Dixcove and Ai^namabee. 
Estimated population, 1,500,000, of whom only about 200 
are Europeans. 

YELLOW FEVER YEARS. 

1778; 1786; 1822; 1823; 1824; 1852; 1853; 1851; 1855; 
1856; 1857; 1862; 1898. 

SUMMARY OF EPIDEMICS. 

1778. 

Although the Gold Coast was colonized by tie Portu- 
gese in the early years of the seventeenth century, the first 
recorded invasion of the territory by yellow fever took 
place in 1778, when an epidemic wave of the disease swept 
almost the whole West African coast occupied by Europe- 
ans. No details of the epidemic are given.^'^ 

1786. 

Another outbreak of yellow fever look place in 1786, 
but the original source of infection i^ not given. It is 
stated, however, that the ship Experim.ent, v/hich had been 
sent by the British Government to assist in the establish- 
ment of trading places, lost many of her men by a ^'malig- 
uant fever. "-^ 



' Berenger-Feraud, p. 56. 

' Berenger-Feraud.p. 58; Valentin, p. 



77. 



230 HISTORY OF YELLOW FEVER. 

1822 to 1824. 

No mention of yellow fever having prevailed along the 
Gold Coast is made from 1786 to 1822. Acccrding to 
Bryson,^^ the mortality was great among the detachments 
which arrived at Cape Coast Castle in 1822, 1823 and 1824. 

1852 to 1857. 

In 1852 yellow fever was imported to the GoM Coast 
and sporadic cases were observed every year from 1852 to 
1857. The Government records, following the usual cus- 
tom, give no detail of this series of outbreaks, and 
Berenger-Feraud^^ disposes of the matter m a few words 
only. 

1862. 

Yellow fever was almost general along the west coast 
of Africa in 1862. The Gold Coast suffered considerably. 
(Berenger-Feraud, page 139.) 



GOREE. 

(See Senegal.) 

GUINEA. 

{See Benin, Dahomey y French Guinea^ Gold Coast, Grand 
Basam, Ivory Coast, Lagos, and Sierra Leone.) 

^'^Bryson, loc. cit, p. 33. 
=^Page 122. 



IVORY COAST. 

Description. 

The Ivory Coast is a part of the coast of Gnmea, be- 
tween Cape Appolonia and Cape Palmas, West Africa, 
Its western portion belongs to Liberia; its eastern half, 
now counted as part of the Gold Coast (q. v.)? ?s shared 
between England and France. The French colony com- 
prises three fortified centres : Grand Bassam, Assinie and 
Dabon. The first two are situated at the mouth of the 
Grand Basam Kiver, on a narrow tongue of land between 
the sea and a shallow lagoon. Dabou is sixty mUes from 
Grand Bassam. Since the date of their establish- 
ment, these colonial towns have been visited nine times 
by yellow fever. In every instance, the disease was im- 
ported. 

YELLOW FEYEE YEARS. 

1853; 1857; 1862; 1863; 1899; 1902: 1903; 1904; 1905. 
SUMMARY OP EPIDEMICS. 

1852. 

In 1852, many localities on the Gulf of Guinea were in- 
vaded by yellow fever.^^ At Grand Bassam the mortality 
was over fifty per cent, among the French troops i-tationed 
at that post. 

1857. 

Grand, Bassam. 

Sporadic cases of yellof fever began to be observed at 
Grand Bassam in February, 1857. The disease pursued 
an uneventful course until April, when it seemed to have 
died out. About the middle of April, the ^3teamship 

==-^ Berenger-Feraud, p. 122. 



232 HISTORY OF YELLOW FEVER. 

Panar,ta arrived froni France, having on board many col- 
onistib. who had been employed to work at the town factory. 
One man came on shore on April 15, was taken sick the 
next day, and died on the 19th. Fifteen days later, three 
more colonists landed. They were all taken ill and died 
between the 12th and 16tli of May. At about the same 
time, a soldier arrived from Dabou, was taken ill and died. 
These new cases revived the epidemic and many who had 
previously been spared were attacked and died. 

During the revival of the epid3mic, the gunboat La 
Tourmente arrived near Grand Bassam, but could not 
reach the town on account of shallow water. The Cap- 
tain was rowed to shore, contracted the disease and died 
during the first days of June. 

We have no data concerning the mortality among the 
natives, but the fatalities among the v\^hite colonists was 
excessive, for, out of a population of 66, there were 22 
deaths.^^ 

The disease did not spread to the other ports of the 
Ivory Coast, with the exception of two imported cases at 
Dabou. 

Dahon. 

In 1857, two employes of a commercial house at Grand 
Bassam went on a mission to Dabiai. Shortly after their 
arrival, the men were almost simultaneously at.acked by 
yellow fever and died. No new cases resulted. 

18G2. 

The Epidemic on Board the DispatcJi-Boat V Archer , at 
Grand Bassam. 

In his account of the epidemic of 1862, Sarrouille gives 
more elaborate details.^^ A reference to our chronological 
tables will show that yellow fever was widespread along 
the west coast of Africa in 1862. Rumors of the existence 

^'^Salis: Archives des Hopitaux du Senegal; Sarrouille, Theses 

de Paris, 1869, No. 150, p. 14. 
=^ Sarrouille: Theses de Paris, 1869, No. 150, p. 21. 



IVORY COAST. 233 

of the disease reached Grand Bassam as earl}^ as the mid- 
dle of the year, but it was not until November that the first 
case was observed in the dependency. On the 16th of that 
month, the French dispatch boat VArclier. which had been 
infected at Saint Paul de Loanda, by communicating with 
the Dialmatli, arrived at Grand Bassam and laiided one 
white and ten native sailors. The white sailor was taken 
ill on the ITth and died on the 20th, with unmistakable 
symptoms of yellow fever. None of the blacks who were 
put on shore at the same time contracted the disease. 

The fever did not spread immediately to the mainland, 
but soon broke out on the vessel. On November 26 the 
second steersman was stricken. The t'ever spread rapidly, 
five deaths occurring between November 28 and December 
5. Dr. Sarrouille himself was attacked. On December 7 
the commandant, thinking that VArcJie/r had been infected 
at Grand Bassam, took on board all the white inhabitants 
of the post which could be sj)ared, and sailed for Dabou. 
But the disease continued to rage on board and by the time 
the vessel reached Dabou, December 12, three more sailors 
had succumbed. The men who had been taken on board 
at Grand Bassam were landed at Dabou and, strange as 
it may seem, not a single case developed among them, the 
pestilence being confined exclusively to the sailors. This 
immunity, in our opinion, can only be explained on the 
ground that the landsmen slept on d< ck, where the in- 
fected mosquitoes had no access, while the poor sailors 
were compelled, in the performance of their duties, to re- 
main below decks most of the time, A\here they were un- 
protected from the bites of the insects. 

On December 12th, when the ship's mechanic died, only 
three of the eleven men who comprised the complement of 
V Archer on November 26, when the first case broke out, re- 
mained, namely, the captain. Dr. Sarrouille and a sailor. 
It was thought that the epidemic had ceased with the death 
on the 12th, but on the 18th the heroic captain, who had 
nursed his comrades throughout the terrible ordeal and 
had seen them die one after the other, was taken ill and 
was soon added to the list of victims. It will thus be seen 
that, out of a crew of eleven^ we have ihe ai)palliiig record 
of ten attacks and nine deaths. Dr. Sarrouille being the 



234 HISTORY OF YELLOW FEVER. 

only one who survived an attack and tbe sailor above men- 
tioned being the only member of the crew who proved im- 
mune to the pestilence. 

Grand Bassara. 

Cases begin to appear at Grand Eassam shortly after the 
death of the sailor landed from F Archer. The outbreak 
was quite severe, resulting in twelve cases and s*x deaths, 
out of a white population of eighteen. 

Assinie. 

The European population at Assinie in 1S62 consisted 
of only five persons — the governor, the resident surgeon 
and three soldiers.-^ About vhe 10th of December, two of 
the soldiers were taken ill and the symptoms diagnosed 
as yellow fever. Both died s few davs later. The gov- 
ernor and the surgeon were then successively attacked, the 
latter dying on the 27th. The former recovered. The na- 
tives of the villages contiguous to Assinie suffered severe- 
ly, but in the town proper there were only four deaths 
among the blacks, making a total mortality of eight. 

General Summary of the Epidemic of lS6i. 

The epidemic which began at Grand Bassam in Novem- 
ber, 1862, was one of the most virulent on record, for out 
of 27 Europeans attacked, 18 died. The cases and deaths 
were as follows : 

Locality. Cases. Deaths. 

On board the F Archer 10 9 

Grand Bassam 12 6 

Assinie (white population only 5) .... . 10 8 



32 23 

The combined white population of Grand Bassam and 
Assinie amounted to 23. As will be seen, this small num- 

^ Sarrouille, loc. cit., ji. 35. 



IVORY COAST. 235 

ber furnished 17 cases and 9 deaths. The most appalling 
mortality, however, was on board of V Archer, where ten 
cases were followed by nine fatalities. 

The disease did not spread to Dabou.^^ '\ 

18G3. 

Sporadic cases of yellow fever appeared at Assinie and 
Grand Bassam in 1863, but almost entirely among the 
natives. We find the record of only one death among the 
Europeans at Grand Bassam, an agent sent by a French 
commercial house to establish a factoi-y at this post. He 
arrived at the '^unhealthy season" and rt^maiuhd three 
months on board a vessel in the harbor. During the 
month of February, thinking that aU danger was past, 
he went on shore. Fifteen days later, he was stricken with 
yellow fever and died eight days after the onset of the 
maladv.^^ 

1899. 

Through some source which is not given, yellow fever 
was brought to Grand Bassam in 1899 and for a time 
threatened to assume epidemical proportions. Strict sani- 
tary measures were adopted, however, and the disease 
was restricted to the vicinity of the original outbreak, re- 
sulting in six cases and ^nq deaths. The infected terri- 
tory extended from the Gold Coast up to and including 
Half Jack on the west.^^ The other African stations were 
not affected. 

1902. 

The epidemic of 1902 broke out -rnddenly and, although 
it lasted hardly a month, was characterized by nearly one 
hundred per cent, mortality. 

On July 14, 1902, a sergeant of infantry, who had only 
been at Grand Bassam two or three weeks, was taken ill 

2^Huard: Theses de Montpellier, 1868. 

^ Sarrouille, loc. cit., p. 41. 

-»U. S. Public Health Reports, 1899, vol. 14, pp. 1336, 1812; 

Annales d'Hygiene et de Medecine Coloniales, 1903, vol. 

6, p. 325. 



236 HISTORY OF YELLOW FEVER. 

with fever. He died on the l>9th ^ith "suspicious symp- 
toms/- but as yellow fever had not been observed in the 
colony since 1899, the case was diagnosed as ''pernicious 
fever" by the attending physician 

On July 20, an Australian prospector, aged 30, who, to- 
gether with three other prospectors, had landed at Grand 
Bassam June 27, died with black vomit, and the authori- 
ties concluded that they were face to face with an invasion 
of yellow fever and cabled the facts to the colonial officials. 
Orders were received to take immediate sanitary measures 
and to make war against mosquitoes. 

The three other pros^Dectors, room-mates of the case 
above mentioned, were successivelv attacked, on the 23d, 
25th, and 26tli of Julv; one recovered, the others died on 
the 30th. 

In the four last cases above noted, bla'jk v jmit was 
present. 

On July 24, a white servant, aged 34, who had been in 
the colony two months, died at the infirmary, alter four 
days' illness. 

On July 24, a notary's clerk, also a new arrival, died 
after three days' illness. A young couple wlio occupied 
the same residence as this young clerk, and Avho nursed 
him through his illness, proved immune, although they 
had arrived from France only six weeks x)reviously. 

Two customhouse officers were taken ill on July 23 ; one 
died on the 27th and the other on the 2Sth. 

An Englishman, aged 26, who had arrived at Grand 
Bassam on June 26, furnished the tenth case. He was 
taken ill on July 25th. He continued to attend to his 
duties until the 28th, when he was f iund in a coma by 
one of liis fellow- clerks. Death, preceded by black vomit, 
took place shortly afterwards. His companion ^as taken 
sick in a few days, but suffered only a slight attack, which 
resulted in an uneventful recovery. 

The twelfth case was an Alsatian who had arrived at 
Grand Bassam on June 27. On the morning of July 27 
he left town to ''isolate'' himself at th« village of Abidjan, 
where he died on July 31 with black v.mit. 

A second death took place outside o^ the town limits, at 
Eloca, a native village near Grand Bnssam. This was an 



IVORY COAST. ^37 

European, aged 33, who had spent a few hours in tlie house 
where the Australians had died. He was taken ill a feAV 
days after his return to Eloca and died on August 2. 

The fourteenth ease was furnished l^y a priest who had 
been doing missionary work along the west coast of Africa 
for six or seven years. He was taken ili August 2 and died 
on the 12th. 

' The last case, a mulatto, had been a resident of Grand 
Bassam since 1894 and had gone through the epidemic of 
1899. He was taken ill on August 12th and died on the 
19th. This is one of the te^\ instances in which a person 
with African blood has died of yellow fever on African 
soil. The disease is generally fatal among the Avhite col- 
onists, but the mulattoes are generally immune while the 
blacks, despite their unsanitary and barbarous mode of 
living, rarely contract the disease. Such has beer the case 
in almost every epidemic, not only at Grand Bassam, but 
along the entire coast of the Dark Continent v*here the 
saffron scourge has manifested itself. 

The epidemic of 1902 may be summarized as follows : 

Grand Bassam, 13 cases; 11 deaths. 

Abidjah, 1 case, resulting in death. Imported from 
Grand Bassam. 

Eloca, 1 case, resulting in death. Imported from Grand 
Bassam. 

Grand total, 15 cases; 13 deaths. 

The source of the ej)idemic has never been definitely es- 
tablished. Some claim it was imported from the Gold 
Coast; others incriminate Senegal, Dr. Rousselot- 
Benaud,-^^ from whose account this resume is made, be- 
lieves that the disease was not imported, but wa^ due to 
extensive excavations made in a lagocm where the debris 
of the epidemic of 1899 had been thrown and left undis- 
turbed since that time. It is needless to explain why this 
hypothesis is untenable. 

1903. 

The epidemic of 1903, following so closely upon the out- 
break of 1902, caused widespread panic throughout the 

2<* Rousselot-Beriaud : Annales d'Hygiene et de Medecine Col- 
oniales, 1903, vol. 6, p. 319. 



2S8 HISTORY OF ITELLOW FESTER. 

colony. According to Gouzien and Le Hardy.^^ the first 
suspicious cases occurred in January. On the 24th of that 
month, a Syrian, who had landed at Grand Bassani in De- 
cember, 1902, and who lived in the natire section of the 
town with seven or eight of his countrymen, died with 
black vomit. The corpse was burned by the authorities 
and the dead man's compatriots were isolated for nine 
days, during which time a strict watch was kept over 
them. 

On January 29 another case was observed, followed by 
death in a tew days. A third case occurred about the same 
time in the person of a customhouse emiDloye. 

The outbreak seemed to subside, no cases being ob- 
served during February. On 3Iarch 3, a sergeant of in- 
fantry died at the infirmary. This death was foliowed by 
another on March 11, in the same room where tht sergeant 
had succumbed. 

The reappearance of the disease caused consternation in 
the town. The cabin where the tv o deaths occurred was 
burned, as was also the clothes and bed-linen of the unfor- 
tunates. 

On March 11, a fatal case was obser^ ed, followed short- 
ly by two cases, which recovered. 

On March 15, a sister of charity died. 

About that time, the Government oidered the isolation 
of the white inhabitants of Grand Bassam. To avoid 
spreading the contagion, this was done by groups of two 
or three, until the town was nearly depopulated. On 
July 17, only 23 Europeans vrere iDresent. 

The fever soon began to show itself at the places where 
the refugees had been sent. On July 19, a death occurred 
at Adjeo, followed by two fatalities at Tmperie on the 23rd. 
On the 27th a death was registered at Arriounna. 

The sixth death at Grand Bassam was furnished by a 
city official who had been two months in ihe colony. 

On July 28, a Catholic priest died after an illness of 
only forty-eight hours. 

On August 1, the white population amounted to 13. 

^^ Gouzien and Le Hardy: Annales d'Hygiene et de Medecine 

Coloniales, Paris, 1904, vol. 7, p. 558. 



IVORY COAST. 239 

On August 3, case occurred at Schneider Plantation, in 
the person of a refugee from Grand Bassam, followed by 
death on the 4th. 

The last case at Grand Bassam occurred on August 7th, 
resulting in recovery. 

The cases and deaths may be summ_arized as follows : 

Cases. Deaths. 

Grand Bassam 10 7 

Adjeo 1 1 

Imperie 2 2 

Arriounna 1 1 

Schneider 1 1 



Total 15 12 

The epidemic was probably a recrudesceuce of that of 
1902, caused by the renewed activitv of the infected 
Stegomyia. 

1904-1905. 

Yellow fever was brought to the verv doors of tLe colony 
in 1904 and 1905. 

The steamship Tibet arrived at Dabou towards the end 
of October, 1904. Her physician had just died from an 
attack of '^pernicious fever," but subsequent events justify 
the assertion that it was probablv a case of yellow fever. 

On the next trip of the vessel to the colony, January 26, 
1905, while in the harbor of Grand Bassam, a case of '^sus- 
picious fever" was reported on board. This proved to be 
the ship's physician, who had taken tlie place left vacant 
by his comrade's death. The patient was well enough to 
be on deck that evening, but fell into a coma on the 28th 
and died on the 29th. He v/as buried on shore. 

A few daj^s later, while the Tlljet was in the harbor of 
Cotonou, the hospital steward was attacked by what was 
pronounced a typical manifestation of yellow fever. The 
case was a mild one and the patient recovered. 

The Tihet was then given free pratique and left for 
Grand Bassam, where she arrived February 24th, and took 



240 HISTORY OF ^"ELLOW FEVER. 

a passenger for France. The man was an inyali'l, of dis- 
sipated habits, who had been in the hospital foi about a 
month and was weak from fever. That same night, while 
at Dabou, he fell into a comatose state and died the day 
following (February 26th) with black vomit.^- 

A perplexing qtiestion now presents itself : Where did 
this man contract yellow fever? Xo '^x^oradlc Oase had 
been seen at Grand Bassam before the eruption of this 
fatal one, and none were observed during the balance of 
the year. The patient came directly from the hosi^ital to 
the ship, did not communicate with anyone and had not 
left his room for nearly a month The rapid evolution of 
the disease precludes the j^ossibility of the patient having 
been infected on board on the 24th, and as be presented all 
the symptoms of yellow fever, even the black vomit, there 
is no gainsaying the fact that he was contaoiinated some- 
icliere. But to take down the map of the world and point 
out that '"somewhere" is the piece de resistance. The only 
loop-hole we see, is the assumption that, when the Tibet 
was in the harbor of Grand Bassam on her first visit (Jan- 
uary 2Gthi, the tmfortunate Frenchman was bitten by an 
infected mosqtiito either at the whs^rf •. r on board the ves- 
sel and afterward had a mild attack of yellow fe^er. Be- 
ing convalescent when transferred to the Tibet, the excite- 
ment incidental to his removal brotiglit on a i elapse, which 
terminated as above set forth. 

This circuitous mode of infection may seem a little far- 
fetched, but it is plausible, and, in the absence of proof to 
the contrary, is just as good as any other theory. 

^Vivie: Annales d'Hygiene et de Medecine Coloniales (Paris), 

1907, YOL 10, p. 121. 



JOHANNA ISLANDS. 

Description. 

Johanna is one of the Comore Islands, in the Mozam- 
bique Channel, between Madagascar and the mainland of 
Africa. Its capital is the walled town of Johanna. 

ALLEGED YELLOW FEVER YEAR. 

1801. 

SUMMARY OF ALLEGED OUTBREAK. 

Bancroft, in his Sequel to An Essay on Yellow Fever 
(1817, page 132), tells of an outbreak of ^'Bulam Fever" 
on board a sloop of war which had stopped at Jrhanna in 
1801 for provisions, water and fuel. Soon after sailing, 
symptoms of a fever "of an unusual kind" appeared among 
those of the crew that had been on the island. The general 
symptoms were: An oppressed pulse, pungent heat on the 
surface, bloated countenance, a dull, heavy, inflamed e^^e, 
violent headache, pain at the epigastric region, and an in- 
vincible irritability of the stomach; the vomiting, in all 
cases, being of a bilious nature and a yellow-greenish as- 
pect, which, towards the fatal termination of the disease, 
assumed a dark-brown olive or chccolate color. In none 
of the bad cases were remissions well marked, and in most 
of those who died, a yellow suffusion of the skin of a 
lemon hue, was conspicuous only a short time previous to 
death; in all, however, after death this appearance was 
common. The discharges by stool manifested a similar 
variety, but they were so highly corrosive and acid as to 
excoriate the anus and nates, and to excite the general 
dread in the patient on the api)roacli of the evacuation. 

Out of twelve men attacked, six died ; those who recov- 
ered did not have the dark colored von j ting and fheir con- 
valescence was extremely tardy. 

With the exception of the alleged outbreak at Madagas- 
c^ar (q. v.), this is the only record o^ yellow fever, or a 



242 HISTORY OF ^"ELLOW FfVER. 

disease simulating that scourge, on tlio eastern shores of 
Africa. Banrr«:>ft says that this sIood of war carje direct 
from England. ^ hiih jjr^cludes the thfMiry of importation. 

We ar J prone to believe that it was simjjlv a yirnlent out- 
break of ijalutlial fever, aggravated by exiiosure and 

fatisrue. 



LAGOS. 

Description. 

La.Q:os is a British colony in Upper Gninea. on the Gulf 
of Benin. The capital, Lagos^ the largest port in Western 
Africa has a population of about 40,000. The population 
of the colony is about 100,000, mostly negroes. Lagos was 
once a noted slave mart. 

YELLOW FEVEE YEAR. 

1864. 

SUMMARY OF EPIDEMIC. 

There is a solitary record of yellow f< ver having invaded 
Lagos ( Berenger-Feraud, p. 141). In 1864, the disease 
was in Sierra Leone and was brought to Lagos by trading 
vessels. The outbreak does not appear to have been of 
much consequence, as it is barely mentioned in the official 
reports. 



MADAGASCAR. 

Description. 

Madagascar, the third largest island in the wor-d, is sit- 
uated in the Indian Ocean, 210 mi^es from the v^qst coast 
of Africa, from which it is separated by the Mozambique 
Channel. It is about 1,000 miles long and has an aver- 
age breadth of 250 miles. Population, 3,520,000. Capital, 
Tananarive. Chief port, Tamatave. The island is under 
French protectorate. 

YELLOW FEYEE AS IT CONCEKNS MADAGASCAK. 

Berenger-Feraud, in the Gazette Medical de Nantes^^ and 
Joseph Jones, in the Transactions of the Louisiana State 
Medical Society for 1879 (page 63), make brief mention 
of yellow fever having been observed in Madagascar in 
1790, but a search through the literature of that vear and 
a careful perusal of the principal works on Madagascar, 
fails to throw any light on the subject. Bancroft, in his 
Sequel of Yellow Fever (page 135) claims that an English 
warship contracte^l a pestilential disease at Mtidagascar 
in 1806, but makes no mention of the alleged outbreak of 
1790. Bancroft's account is as follows: 

In the year 1806, a seventy-four gun ship of tho British 
navy stopped at Madagascar for the purpose of obtaining 
fresh beef, vegetables, fruit, wood and water. In conduct- 
ing these duties it was necessary to « mploy mai-y of the 
men ; and of all the parties thus employed, none remained 
on shore during the night, except a guard of marines, sent 
in the evening on purpose for the protection of watetr 
casks, etc. ; and it was so arranged thai no man had occa- 
sion to be out of the ship more than one night. Notwith- 
standing these precautions, a fever of malignant nature ap- 
peared among the marines, and of twenty-four attacked 
in a violent degree, six fell victims to the disease. The 
symptoms here were not exactly similar to those wit- 

* 1883-4, vol. 2, p. 6. 



MADAGASCAR. 245 

nessed in Johanna f^ death in several cases was sudden 
and unexpected, preceded by a violent burning sensation 
at the epigastrium, which was only a precursor of death 
by a few hours, and in one case by a fcAV minutes. In 
these cases neither Avas a ^^ellow suffusion of the skin con- 
stant, nor the eyes so highly inflamed, nor the countenance 
so much flushed as in the fever of Johanna : but a sallow, 
dingy, disagreeable aspect of the countenance prevailed. 
In some of these cases the ship-s surgeon Avas inclined to 
think the individuals in a state of intoxication, from the 
very great degree of vertigo and staggering present; but 
a short time served to convince him of his error. This 
variety of appearance in the two diseases this officer 
ascribed to peculiarity of constitution only, and not to any 
difference of climate ; those who vvere affected at Johanna 
were young and recently arrived from their native climate ; 
whereas the people subjected to the Madagascar fever had 
been some length of time in India, and had but lately ar- 
rived from a long cruise of four months, the greater part 
of which they had subsisted on salt provisions, and symp- 
toms of scurvy had appeared among them for some time 
before their arrival at Madagascar. 

. This outbreak was certainly not yellow fever. Nowhere 
can we discover in Bancroft's account any mention of 
previous contamination of the warship, and unless the 
vessel stopped at some infected port on its way from Eng- 
land to Madagascar, the contagion which prevailed on 
board was not, and could not have been, under the wildest 
stretch of the imagination, yellow fever. The mode of 
propagation of this disease is now too well established to 
need elucidation, and, unless the mosquitoes of Mada- 
gascar were imbued with the venom of infection simply for 
this special occasion, the incident can positively and for- 
ever be dismissed as being puerile and chimerical. It is a 
well known fact, however, that palndial fever reigns with 
great intensity in the litoral of the island and commits 
fearful ravages among the whites. In this connection, the 
historic words of Eadama, King of the Hovas, \shen con- 
fronted with invasions by the FrcLch, "I have at my ser- 
vice the great General Tago (fever) and in his hands I'll 

^^ See article on Johanna Island, in this volume. 



246 HISTORY OF YELLOW FEVER, 



leave the whites for a while; 1 ha^e no fear of the results,^ 
proved terribly prophetic, for the shores of the great 
island are so thickly studded with the gravestones of the 
invading French, that Madagascar has been christened 
Le Tomheaii des Franca is. 



MADEIRA ISLANDS. 

Description. 

The Madeiras are located in the Atlantic Ocean, about 
440 miles off the west coast of Africa and consist of the 
islands of Madeira and Porto Santo and three islets called 
the Desertas. The group belongs to Portugal. Popula- 
tion, 123,841. Capital, Funchal^ on the island of Madeira. 



1738. 



YELLOW FEVER YEAE. 



SUMMAPiY OF EPIDEMIC. 



Although the Madeiras have been known to Europeans 
for four hundred and seventv-six years, only once has yel- 
low fever invaded the group. Like the Canary and Cape 
Verd islands, the Madeiras are directly in the path of com- 
merce between Europe and Africa and were no doubt the 
rendezvous of the delightfully unsanitary galeons, buc- 
caneers, slave-traders and gentlemanly cut-throats of by- 
gone days; but, strange and inexplicable as the ^otatement 
may seem, the dreaded peste, although it devastated the 
other islands off the African coast, only found lodgment 
once on the shores of this salabrious Portugese possession. 

This solitary record of the appearance of the ^'Ameri- 
can Pestilence" in the Madeira Islands may be found in 
an old Portugese work published nearly two hundred years 
ago, by Jose Rodriguez de Avreu,^* phvsician to King 
Juan Y, of Portugal. No details are given of this inva- 
sion, beyond the statement that it caused much mortality 
in the city or Funchal. 

From 1738 to this day, yellow fever has never been ob- 
served at the Madeira archipelago. 

How can this immunity be explained? Only by 
hypothesis, and as hj^potheses are generally concocted of 
such volatile ingredients that they collapse of their own 
weight, we shall not indulge in any, but will sum up the 

** Jose Rodriquez de Avreu: Historiologia Medica, vol. 1, p. 620- 



248 HISTORY OF YELLOW FEVER. 

whole matter in five little words: TJie tihsenc^ of the 
Stegoinyia. This, in our opinion^ is the true explanation. 
It is not a hypothesis, but a fact, that the ^tegomyia Cal- 
opus, the only active agent in ,the transmission of yellow 
fever, does not flourish in tlie Madeira group. The insect 
was imported once to the islands and that solitar}^ instance 
furnished the delightful little city of Funchal the only epi- 
demic of yellow fever which has ever invaded that locality ; 
and, as soon as the climatic conditions i f the island proved 
hostile to the propagation of the mosquito and the im- 
ported insects died, the pestilence which they had pro- 
duced ceased and the old-time health con-litions of the 
country re-established themselves and have endured to the 
present day. 



MOROCCO. 

Description 

Morocco is a country occupying' the northwest extremity 
of Africa. Area, about 200,000 squaro miles. Popuhition, 
6,000,000. The empire has three capitals — Fez, with an 
estimated population of 100,000: Morocco, with 40,000 
souls, and Tangier (the diplomatic sea':), estimated to con- 
tain about 14,200 inhabitants. 

YELLOW FEVER YFAR>S. 

1804 ; 1881. 

SUMMARY OF EPIDEMICS. 

1804. 
Penon cle Velez. 

The only recorded epidemic of yellov; fever in northwest 
Africa took place in 1804, at Penon de Velez, a fortified 
Spanish fortress situated on a lofty r(.ck in the Mediter- 
ranean, 80 miles southeast of Ceuta. Morocco. In the 
last years of the eighteenth century, this islet was used as 
a prison for refractory presldarios^ or galley slaves. It 
is now a Spanish penal colony. 

In 1804, yelloAv fever was epidemic almost throughout 
Spain and the infection was carried to Penon de Velez by 
tradespeople and soldiers from Malaga, between which 
port and Morocco there was constant and uninterrupted 
communication. No detailed account could be found of 
this epidemic. Fellowes^^ and Moreau de Jonnes^^ inform 
us that the disease was imported from, Malaga, and was 
widespread among the garrison and gallev slavis which 
formed the sole population of the islet, but give no in- 
formation regarding the number of cases or the latalities. 

^"Fellowes: Reports of the Pestilential Disorders of Andulasia 
which appeared at Cadiz in the years 1800, 1804, 1810 and 
1813(London, 1815), p. 101. 

^® Moreau de Jonnes: Monographie Historique et Medicale de 
la Fievre Jaune des Antilles (Paris. 1817), p. 341. 



250 HISTORY OF YELLOW FEVER. 

18S1. 

Tangier. 

The second and last invasion of Morocco by yellow fever 
took place in 1881, at Tangier, one of the capitals of the 
empire, situated at the entrance to the Strait of Gibraltar, 
which had then an estimated population of 15,000. It is 
unfortunate that only a bare mention :s made of this out- 
break in the consular reports. There were onlv a few 
sporadic cases and no deaths, ■" The source of importation 
is not given. 

^' National Board of Health Bulletin, 1881-1882, vol. 3, p. 337. 



SAINT HELENA. 

Description. 

Saint Helena is a volcanic rock in the South Atlantic 
Ocean, TOO miles south-east of the Isla/id of Ascension, and 
1400 miles west of the west coast of Africa. It is 10 1-2 
miles in length, 7 miles in breadth and belongs to Great 
Britain. Population, 4,116. Capital, James Town, on 
the north-west shore. Saint Helena i:? famous in history 
as haying been the living tomb of the Great Napoleon from 
the date of his banishment, 1815, to his death. 1821. 

YELLOW FEVEE YEAK. 

1830. 

SUMMARY OF EPIDEMIC. 

It is surprising that yellow fever has never invaded 
Saint Helena, for, previous to the cutting of the Suez 
Canal, the island was a favorite port of call fcr vessels 
bound to and from India, by way of the Cape of Good 
Hope and the inhabitants did a large Trade in furnishing 
these vessels with provisions and other supplies. The only 
explanation is found in the absence of the Stegomyia Cal- 
opus from this lonely rock, as vessels infected with yellow 
fever no doubt stopped long enough a^^ James Town in its 
palmy days to communicate the disease to the inhabitants. 

The outbreak of 1830 was solely in the harbor and did 
not spread to the shore. It took place en board the British 
ship Sybille, under the follovv^ing circumstances (Bryson, 
loc. cit, p. 57) : 

The Syhille was infected by some vessel attached to the 
British South Atlantic squadron in 1829 and suffered 
much from the ravages of yellow fever. On September 1, 
1829, she arrived at Saint Helena. The epidemic had ceased 
and no one was on the sick list. She shortly sailed on a 
cruise and met with the Black Joke^ T\?th which she com- 



252 HISTORY OF YELLOW FEVER. 

municated. This vessel had just recovered from a severe 
visitation of yellow fever. The disease again broke out 
on board the Sybille. She returned to Saint Helena and 
anchored in the harbor of James Town on ]\ larch 22, 1830. 
The disease was widespread amono- the crew, there being 
26 cases and 6 deaths while the ship was at Saint Helena. 
The fever was confined to the Syhille. 



SAINT THOMAS. 

Saint Thomas is an island in the Gulf of Giuinea, belong- 
ing to Portugal. Area, 145 square mikis. Capit?.l, Chaves. 
Population, 29,441. 

YELLOW FEVEE YEAPvS. 

/ 1558; 1588.. 

SUMMAEY OF EPIDL MICB. 

1558. 

AVe find only two instances of the appearance of yellow 
fever on the island of Saint Thomas. There is no doubt 
that the disease has prevailed there o,?. numerous occa- 
sions, as the Portugese have never been over-strict in en- 
forcing quarantines in their colonial possessions and the 
locality has always been a nest-egg of smugglers and lax 
maritime transactions. But the available sources of in- 
formation, as is ahvays the case wheij the colonies - of 
Western Africa are concerned, are either sterile or untrust- 
worthy, so we shall confine our observations to the two 
outbreaks herein noted. 

According to Berenger-Feraud {loc. cit., p. 27), yellow 
fever was observed among the white settlers of the island 
in 1558. Beyond this mere mention, iio details are given. 

1588. 

The same authority (p. 27) also informs us that Bird 
and Newton, English explore .'s, and their crews, were at- 
tacked by yellow fever at Saint Thomas in 1588. Where 
the disease was contracted, ^v^hether it was then prevailing 
on the island or was brouj^ht there by the explorers, our 
source of information doefe not reveal. 



SENEGAL. 

Description. 

Senegal is a French colonial deijendency in West Afri- 
ca, in Senegambia, comprising the island and town of 
Saint-Louis, at the mouth of the Senegal Kiver, the island 
and town of Goree, Albunda on the Gambia, and other 
stations south of Cape Yerd. It was first settled by the 
French in the beginning of 1600, taken by the English in 
1756, retaken by the French in 1759 and 1779, and subse- 
quently held by the English until 1814, when it again 
came under control of the French, who have retained pos- 
session to this day. Capital, Saint-Louis. Other towns 
and stations: Goree, Dakar, Rufisque, Thies. 

Senegal being one of the most important colonial pos- 
sessions on the West Coast of Africa, having extensive 
trade relations with America and Europe, a description of 
its principal centres of population will not be out of place 
in this volume. The reader will thus be in a better posi- 
tion tc understand the radiations of the many epidemics 
which have ravaged this distant land. 

Saint-Louis. 

Saint-Louis, capital of the French possessions in Sene- 
gambia, was founded in 1626. It is situated on an island 
of the same name, at the mouth of the Senegal River. It 
has fine public buildings and mission schools. The white 
I)opulation occupies the centre of the is 'and, while the huts 
of the natives are located at both extremities. The streets 
are large and macadamized in the business section, but the 
houses, with few exceptions, are of ancient construction. 
Several bridges over the small arm of the Senegal connect 
the island with the peninsula of Barbary, a narrow sand- 
bar, on which are located the native villages of Guet N'Dar 
and N'dar Toute. The cemeteries are located at Sorb, on 
the mainland and separated from the island by (he great 
arm of the Senegal. A single bridge connects Sorb with 
the capital. 



SENEGAL. 255 

The natives are exceedingly filtlij^ in their Labiis?. Those 
residing in the European section of the citj^ occupy the 
basements, where they operate small stores. In the small 
court-yards attached to these houses, they keep chickens, 
hogs, sheep and often cows, and when the yards become 
overcrowded, which is a common occurrence^ tliese ani- 
mals are often quartered in the living apartments. Under 
such conditions, it is not surprising that the lieaith of the 
city is always on the Avrong side of the balance 

Saint-Louis has a population of 15,758, mostly natives. 
The white population is transient and generally J eaves for 
Europe at the beginning of the rainy season. 

Goree. . 

The rocky island of Goree, which is entirely occupied 
by the town of the same name, lic-s in the Atlantic Ocean, 
south of the Cape Yerd Peninsula It is directly opposite 
Dakar, with which town it is so closeiy allied that the 
name Goree-Dakar is now generally used when alluding to 
the twin cities. It is claimed to be the healthiest place in 
West Africa. The native quarter is composed of grass; 
huts, but the houses of the Europeans are of fair construc- 
tion and decorated with fine flowering plants and shrubs. 
The elevation of Goree above the sea level varies from 2 
metres on the northwest to 34 on the southeast 

Goree was for years the principal port of the colony, 
making rapid strides in population i^nd commercial im- 
portance, but it is now being outstri^^ped by Dakar and 
Eufisque. 

Population, 2,452, mostly natis^es. The white mer- 
chants, as is the case everywhere throughout Senegal, gen- 
erally sail for Europe every year at the beginning of the 
warm season. ; 

Dalcar. . 

Dakar is situated on the continent, almost at the ex- 
treme point of Cape Verd, and is 1 1-2 miles from Goree, 
from which it is separated by an arm of the Atlantic 
Ocean. Up to very recent years Dakar was an obscure 
negro village and was simply a vast necrophlle, having 



^56 HISTORY OF YELLOW FEVER. 

been used as a burying ground for the inliabilants of 
Goree from time immemorial. In the eighties, its natural 
advantages began to be recognized and European commer- 
cial houses established agencies there. The building of 
modern residences followed and to-dav the town occupies 
a foremost place in the affairs of the colory. It is 163 
miles from Saint-Louis, with which it is connected by rail. 
Population, 3,417, of which only a few hundreds are 
Europeans. 

Rufisque. 

Rufisque, the second city jn Senegal from a point of 
population, is situated on the Atlantic Ocean, opposite 
Goree, about ten miles from Dakar, and is the principal 
station on the Dakar-Saint-Loui^ rat'road. Population. 

5,280. 



YELLOW FEVER YEARS. 



1759; 1766; 1769: 1778; 1779; 1828; 1829- 1830; 1837; 
1859; 1866; 1867; 1872; 1878; 1879; 1880;. 1881; 1882; 
1900 ; 1901 ; 1905. 

SUMMARY OF EPIDEMICS. 
1759. 

The first appearance of yellow fever on the mainland of 
Africa, according to Lind,^^ occurred at Senegal in 1759. 
We can find no details of this inyasicn. It would cer- 
tainly proye interesting to be able to trace the origin of 
this outbreak, which planted the seeds of a disease hereto- 
fore unobseryed on the continent of Africa, and which was 
destined to commit such fearful ravages among the unfor- 
tunate pioneers sent to colonize its shujes. 

1766. 

Goree and iSaint-Louis. 

The second appearance of yellow fever on continental 
Africa took place in Senegal in 1766, when the towns of 

^^Lind: An Essay on Diseases Incidental to Europeans in Hot 
Climates, vol. 1, p. 51. 



SENEGAL. 257 

Goree and Saint-Louis lost nearly their entire wiiUe popu- 
lation, composed of French soldiers and traders. No de- 
tailed accounts of this epidemic aie obtainable, our 
authorities (Lind and Berenger-Feraiid ) being deplorably 
uncommunicative on this score. 

1709. 

Berenger-Feraud (page 55) goes into more explicit de- 
tails concerning the outbreak of 1769, but is certainly not 
prolix. We could obtain no statistics, but learn from his 
account that the French troops sent tv capture Galam, on 
the Senegal Kiver, were so decimated by yellow fever, that 
there were not enough men left to undertake the task. 

1778. 
Saint-Louis, 

The epidemic of 1778, which is the first on African soil 
where details are obtainable, was murderous in its inten- 
sity and almost depopulated the dependency of its white 
settlers. Senegal was then in the turmoil of war, the 
English having wrested the colony from the French. The 
fever first apiDcared on the Gold Coast, whence it was 
brought to Sierra Leone, which, in its turn, infected Gam- 
bia. From Gambia, it spread to Goree and thence, accord- 
ing to Hirsch,^^ to Saint-Louis. 

The progress of the disease in the town of Saint-Louis 
is one of the saddest pages in the history of the colony. 

We cull our information from an old work published by 
Schotte in 1782, which gives a comprehensive account of 
the rise and fall of the epidemic. ^^ Schotte, who was sur- 
geon-in-chief of the British garrison at Saint-Loui. in 1778, 
first wrote this treatise in Latin, but was finally prevailed 
to publish it in English. The work Avas considered of such 

2'Hirsch: Handbusch der Historich Georgraphischeii Path- 
ologie, Stuttgart, 1881.. 
• *" Schotte: A Treatise on the Synochus Atrabiliosa, Jjondon, 

1782. 



258 HISTORY OF YELLOW FEVER. 

importance at the time, that it was translated into French 
and German. 

The first case in Saint-Louis was imported from Goree- 
Dakar and was observed in the hospital on August 3, ter- 
minating fatally on the 7th. The last death w^as that of 
Governor Clarke, the commandant of the island, on Sep- 
tember 18th. 

Schotte observes that up to the end of July. 1778, the 
garrison and the inhabitants of Senegal were, for that time 
of the year, remarkably healthy. Iii the beginning of 
August, ''a sudden and most dreadful disease broke out," 
which, raging until the middle of Sejtember, carried off 
the greatest part of the Europeans and a great number of 
the native mulattoes and blacks. The whites suffered 
much more, in proportion, than the mulattoes and the 
latter much more than the blacks. The few who had es- 
caped the fury of the pestilence were not attacked after 
September 18th ; but those who had recovered were seized 
with relapse during the following month and some died 
as late as December. 

The course of the disease was frightfully rapid. There 
was hardly a day between the 9th of August and the 18th 
of September without one or two deaths. Out of so small 
a population as 92 Europeans, we find the melancholy 
record of four deaths on August 28d, four on the 26th, 
three on the 27th and five on September 5th. 

The total number of deaths reached 59. Eight of the 
convalescents were still too feeble to walk when the French 
took possession of the island on January 28, 17'^9. 

Schotte, who was a valorous champion of African ende- 
micity of yellow fever, believes thet the disease originated 
spontaneously on the Gold Coast and was then spread by 
contagion to the localities mentioned iu this account. As 
'the French and English were at loggerheads, however, and 
probably drew on their West IndiVn fieets for transports 
and blockade runners, it does not require a gigantic stretch 
of the powers of observation to see how ea•=^ily the disease 
could have been imported to the west cr.ast of Africa. 



SENEGAL. 259 

Vlid. 

Saint-Louis. 

The French, undaunted by the many reverses and the 
rava«jes of disease which had marked their attempts to 
colonize Senegal, determined to recapture Saint-Louis, 
and, in 1779, sent a force of about 200 men, headed by the 
Due de Lauzun, to dislodge the British. The soldiers were 
recruited from the crack Walsh Kegiment, the Queen's 
Kegiment and volunteers and were a fine body of men, vig- 
orous and healthy. The invading force arrived afc their 
destination January 29, 1779, in the dead of night, intend- 
ing to take the garrison by surprise,^ but they found that 
not even a solitary sentry guarded the place, and the 33 
Englishmen who had survived the terrible epidemic which 
had just come to a close, too weak and disheartened to 
offer any resistance, surrendered unconditionaUy, and 
were sent to France as prisoners of war. Two were 
drowned by the upsetting of a boat at the mouth of the 
Senegal and three died in transit, so that out of 99 men 
which originally comprised the. garrison, only 28 reached 
Europe alive. 

But the bloodless victory achieved by the French was 
destined to have a terrible .sequel. The landing of these 
unacclj mated soldiers in this charnel house of disease acted 
like oil upon a smoldering fire and ^^be pestilence soon 
broke out with renewed fury. In the space of a few 
months, the expedition, which had started out ?o auspi- 
ciously, was almost annihilated. The exact number of the 
invading force is not given, bat Lejemble^^ informs us that 
on the mortuary register of Saint Louis for 1779, kept at 
th^t time by the parish priest^, appear the names of one 
hundred and eighty soldiers ! A melancholy record, to be 
sure, but what of it? Senegal was oncf^ more a French pos- 
session, and when the news of the capture of the. place from 
the hated Englishmen reached Pai'is, there was much re- 
joicing over the glorious deed. Such l^ the egoism of the 
people. Life is short, glory imperishable, and it mat- 
tered not if a hundred or so brave men laid down their 

^^Lejemble: Theses de Paris, 1882, No. 91, p. 19. 



260 HISTORY OF YELLOW FEVER. 

lives for the honor of their country, so long as their mission 
was crowned with the laurel of triam}»h. 

1828. 

Goree-Dakar. 

For liftT years, Senegal was free from yellow fever. In 
1828, the French ship La Bordeluise, infected at Sierra 
Leone, brought the disease to Goree-Dakar (Berenger- 
Feraud, p. 105). Many soldiers attached to the garrison 
were attacked, but the outbreak was of short duration and 
was not followed by much mortality. On the Bordelaise, 
out of a crew of 50, there resulted 31 cases. The number 
of fatalities is not stated. 

1S29. 
Goree-Bakar. 

In the beginning of 1829, a slave-ship and a pirate were 
captured by the French off the Gold Coast and brought to 
Goree- Dakar. "^^ The sailors from the pirate ship were 
taken sick and died at the military hospital at Goree. 

The disease soon manifested itself in the town. In 
three months, out of 113 European residents, 11 died. 

ISSO. 
Goree-Bakar. 

The epidemic which radiated from Goree-Dakar in 1830, 
begaU; withotit any j^revious warning, in a mosc remark- 
able manner, as will be seen from th*^ account of the out- 
break given below, taken from the writings of three emi- 
nent French authors, Berenger-Ferat-d, Duval and Le- 
jemble.'^-^ The facts are as follows • 

On Jtme 13, 1830, a religious festival was in progTess at 

*^ Berenger-Feraud, p. 107. 

*^ Berenger-Feraud, p. 107; Riival, La Fievre Jaime a Goree 

(Bordeaux), 1883, p. 16; Lejemble, Theses de Paris, 1882, 

No. 91, p. 20. 



SENEGAL— 1830. 261 

Goree and a great number of people thronged the streets. 
AYhile the jollification was at its height, a number of Sis- 
ters of Charity ^Yeve taken ill and soon gave unmistakable 
evidences of yellow fever infection. Ti! a few days, the 
epidemic was in full sway and between its inception and 
the first days of August, when the last cases were ob- 
served, out of a white population of 150, there resulted 144 
eases and 85 deaths. 

From Goree, the fever spread to the adjoining negro 
villages in the Cape Verd peninsula and was especially 
severe at Gandiole and Guet N'dar. 

Saint-Loui^. 

During the first days of August, a white woman resid- 
ing at Saint-Louis visited the market-x>lace at Guet N'dar, 
where a fair was in progress, and returned home the same 
day. On August 4, she was taken ill with fever and died 
in a few days. A young mulattress vho had nursed this 
woman was taken ill and succumbed. A notary's clerk, 
who assisted in taking an inventory of the possessions of 
the white woman, furnished the next victim. From these 
cases, the disease propagated itself throughout the town. 
Saint-Louis, which had a white x>opvilation of 650, suf- 
fered cruelly, for out of 600 cases, there resulted 328 fatali- 
ties. Out of ten physicians, eio:ht were attacked and six 
died.^^ 

Probable Cause of the EfAdemic. 

For a long time epidemiologists were at a loss to account 
for the cause of this fulminating outbreak, which seemed 
to have sprung from the ground. No suspicious vessels 
had been observed in the harbor of Goree at that period 
and the entire colony was in a perfect sanitary condition. 
Some tried to prove that it was a re -awakening of the 
"germs" of the epidemic of the previous season and even 

*^ Berenger-Feraud's statistics say that out of 12 physicians 10 
were attacked and 6 died; but Duval and Lejemble attest 
to the correctness of the figures given in the above ac- 
count. 



262 HISTORY OF YELLOW FEVER. 

Berenger-Feraud half-heartedly espoused that theory. 
This view was no doubt plausible year,s ago, but its ludi- 
crousness at the present age is too apparent to need com- 
menting upon. The elusive yellow fever germ may be 
eaten for breakfast, lunch and supper, yet no iH results 
will follow; you can take it by its caudal appendage and 
toy with it from sunrise till moonset, smear it all over 
your body, bite its head off or swallow it in your milk or 
pousse-cafe — you may do all this and vet remain healthy 
and frisky. But let a Stegomyia which has taken a 
draught of blood from a yellow fever sufferer in the first 
stages of the disease bite you, and if you are not an im- 
mune^ it's a chance out of a thousand that you will con- 
tract the disease. 

The outbreak at Goree in 1830 can easily and satisfac- 
torily be elucidated. All we have to do, is to take a peep 
into the past and see what was happening in that far-off" 
land at the time of the outbreak. As we ha\e already seen, 
the inhabitants were celebrating a religious feast, and, as 
is usually the case with celebrations of the Catholic 
church, the whole zeal of the people was concentrated in 
making the event as gay as the solemn rites of the Church 
would permit. Flags, decorations and bunting were used 
with profusion. Berenger-Feraud anr^ Lejemble inform 
us that, for some days previous to the <.'elebration, the Sis- 
ters of Charity were busy making odds and ends with a 
lot of bunting which had been stored ir* an out-of-the-way 
room since the epidemic of the year before. The room had 
never been aired since the rags were placed thert. When 
the go'od sisters removed the lot, the mosquitoes, which 
had been hibernating during the wip(er, Avere liberated 
and, famished after such a' long fast, fed eagerly apon the 
blood of the populace, propagating the germs of the terri- 
ble disease far and wide. 

1837. 

Goree-Dakar, 

The epidemic of 1837 was the result of flagrant neglect 
on the part of the authorities of Goree-Dakar. Since the 
beginning of June, rumors of the txisti^nce of yellow fever 



SENEGAL. 263 

at Bathurst, in Gambia, reached the town. In the be- 
ginning of July, the British Government sent to Goree- 
Dakar for medical assistance and the surgeon-in-chief of 
the colony. Dr. Dupuis, was sent to the afflicted locality. 
He returned on July 21 and reporterl that the fever had 
subsided at Bathurst, but advised that strict quarantine 
be maintained. On August 12, a coaster arrived at Goree 
from Bathurst, having on board three Europeans. In 
spite of the warning of the colonial surgeon, the vessel was 
allowed free pratique and two of th.^ white passengers, 
who were ill, were admitted into the hospital. The third 
passenger Avas next attacked and a]l tlree died with un- 
mistakable symptoms of yellow fever. The disease soon 
manifested itself in the towm and lasted until November 
23, during which time, out cf a white population of 160, 
there were 80 cases and 46 deaths.^- 

The French ship Malouine,'*^ which Isad been sent by the 
French Government to found a town ut the mouth of the 
Casamanza River, in Senegambia, wns contaminated at 
Goree and experienced a severe epideaiic. Out < f a crew 
of 57, there were 42 cases. 

Saint Louis. 

The fever was introduced from Goree into Saint-Louis 
late in the year, but did not become epidemic. About a 
dozen cases were observed.^"^ 

1859. 

For twenty-two years Goree Guarded itself against yel- 
low fever invasion. On August 9;. 1859, the disx)atch boat 
Le Ruhis arrived at Goree from Bathurst, where the fever 
was prevailing, with two sick passengers, the vicai-general 
and a merchant. The vessel was aH<>wed free pratique 
and the patients transferred to the liospital. The mer- 
chant recovered, but the priest died on the 12th. From 
that date to September 30, no other cases were observed, 

*'Dupont: Archives de Medecine Navale, 1880, vol. 34, p. 262. 
*^ Duval: La Fievre Jaune a Goree (Bordeaux, 1883), p. 17. 
*^ Berenger-Feraud, p. 111. 



264 HISTORY OF YELLOW FEVER. 

when the death of a merchant was recorded. Th's. was fol- 
lowed by another death on October Irt. The physician 
who attended these two cases contraried the disease and 
died on October 12. The disj.ase ther became T\idesj)read 
and there were 54 deaths in October, 25 in Xoyember and 
6 in December. Out of a white i^opnlation of 267, there 
were in all 244 casese and 162 deaths."*^ 

Saint-Louis 

The infection spread from Goree to Saint Louis, result- 
ing in 41 cases and 11 deaths.^^ 

1566. 

Goree. 

The epidemic of 1866 is directly traceable to Gambia. 
Xews of the existence of yellow fever along the coasts of 
Sierra Leone and Gambia reached Goree early in May and 
measures were at once taken to i3revent importation of 
the disease. On August 3, a coastinsr ressel, the Marie 
Antoinette, arrived from Bathurst and, through false 
representations, was admitted to pratique. It y, as after- 
wards discovered that the vessel did n«:t have a clean bill 
of health. The captain was arrested and fined heavily, but 
the evil had already been done. On September 15, a case 
of yellow fever erupted in the town, followed by sporadic 
cases. The epidemic lasted until January 27, 1867, re- 
sulting in 249 cases and 110 deaths.''^ 

The civil population of Goree in 1 866 was as follows : 

^^Berenger-Feraud; Duval; Lejemble. 
** Berenger-Feraud, p. 135. 

"•Cedont: Archives de Medecine Navale, Paris, 1868, vol. 9, 
p. 334. 



SENEGAL — 1866. 265 

Natives (blacks) 2,500 

Mulattoes, Males , 335 

Mulattoes, Females , . 431 



Europeans ( whites ) , Males . 55 

Europeans (whites), Females ..... -18 



766 
103 



3,369 
Military population (white) ... . . 165 

Total 3,534 

The cases and deaths were distributed as follows: 

Cases. Deaths. 

Whites 242 107 , 

Mulattoes '..... 4 2 

Blacks 3 ' 1 

Total - 249 110 

It will thus be seen that out of a total white population 
of 268, there resulted 242 cases and 107 deaths. The mulat- 
toes, numbering 766, furnished 4 cases, followed by 3 
deaths, while the blacks, 2,500 strong, had onlv 3 cases, 
with 1 death. This remarkable immuiiity has always pre- 
vailed among the blacks, not only in x\fric?., but through- 
out the Avorld. 

Dakar. 

The proximity of Dakar to Goree and the unrestrained 
communication between the two towns, could not fail from 
resulting in the infection of the latter. 

The first case in Dakar was observed on October 12tli, 
followed by death on the 14th. Prom that date until the 
end of the epidemic, there resulted 80 cases and 36 deaths, 
distributed as f oIIoavs : 

Cases. Deaths. 

Civilian population 24 11 

Military population 56 25 

80 36 



266 HEsnmir of teujow ekweo.. 

The last death at Dakar oeenrred on Jamiaiy 21^ 1867. 

Oil' f^^^ fsfui'ri'i'fl c-g:^^ 

The gunboat Surprise was the unij yessel which did not 
take any jirecantions against infection and it was also the 
only one to experience a Tisitation of the dis^ise. On 
Xovember 5th, while in the harbor cf Dakar, the first case 
manifested itself on board. Nearly the entire crew was 
attacked, resulting in 14 deaths. 

Rufisque and Eedhnhm. 

From Dakar, the f erer spread to Rnfisque and Sedhnion, 
but was not severe. It will be seen below how the infection 
was carried from Bnfisqne to Orir^e ihe following Tear 

(1867). 

Saint-Louis 

Thanks to the rigid quarantine observed by the health 
officers, not a single case was observed at Saint-Louis. 

1867. 

In October, 1866, a derk emplcytd in Bufisque who had 
gone on a visit to Dakar, was taken ill on his return home 
and died in a few days. His employer sent to France for 
a new clerk, who arrived in January 1867. The new-comer 
was given the same ioom which his predecessor had occu- 
pied and soon shared the same fate. In April, another 
clerk arrived from France, was given the same living 
room as the two employes who had died of fever. A few 
days after his arrival, he was taker, ill and -died. A third 
unfortunate shared the same fate. A friend of the latter, 
who had been his room-mate on b*iarl the ship which 
brought him from France, visited him while he was in the 
first stages of the disease, and, taking pity upon his lone- 
liness, resolved to nurse him. He soon contracted the sick- 
ness, and, together with his companion^ was transported 
to the Hospital of Goree, where b«jth »»atie^3ts died a day 
or two after. The ne^*^ of the reappearance of yellow 



SENEGAL. 267 

fever in the town created profound cousteriiation and the 
governor ordered the embarkation of all the troops on 
board the Crocodile and VEtoile and transported them to 
Saint Louis. Shortly afterwards, the disease broke out in 
Saint-Louis and lasted until the cool season. 

The disease spread to Leybar^ Lamj.sar and other mili- 
tary posts of the colony, where many cases and deaths oc- 
curred. 

The cases and deaths in the localities affected by the epi- 
demic of 1867 are not given by Berenger-Feraud, Lejemble 
nor Duval, from whose works the above resume is made. 

1868. 

According to the London Medical Times and G-azettey^'^ 
yellow fever was present in Senegal iii 1868 and was im- 
ported to the Cape Yerd Islands (q. v.) by trading vessels 
from Goree-Dakar. The French authors deny thut the dis- 
ease was in Senegal that year and implicate Sierra Leone 
in the importation. 

1872. 

Goree-Dal<ar. 

On October 5, 1872, the ship Baal arrived at Gjoree- 
Dakar from Bathurst, where yellow fever was raging, with 
three European passengers, and applied for pratique. 
This was refused by the health officer in charge. Dr. Ber- 
enger-Feraud. The merchants uf the town protested 
against what they considered harsh measures, asserting 
that there was no sickness on board the Baal, but their ob- 
jections were overruled and the vessel ordered to the 
quarantine station at Dakar, Much p«^essure was brought 
to have the order revoked and the governor was about to 
yield, when the quarantine officer repo^ ted that one of the 
white passengers had been taken ill with fever. The pa- 
tient was at once taken to the lazaretto, where he expired 
on the 9th. A second passenger was taken ill and died 
on the 10th. The third, a Spaniard, who had had yellow 
fever at Buenos Ayres the year before, was not affected.^^ 

f^ Medical Times and Gazette, London, 1869, vol.. 1, p. 119, 
^^Berenger-Feraud, p. 147. 



268 HISTORY OF YELLOW FEVER. 

Shortly afterward, another vessel from Batharst fur- 
nished a third case, which also resnlt'^d in death at the 
lazaretto. Only one inhabitant of Dalcar was attacked, a 
soldier who had been one of the healtL -guards around the 
lazaretto, and who died in a few days after the on&et. 

It will thus be seen that of the four persons attacked, all 
died, and the salvation of the colony v/as no doubt due to 
the energetic measures taken by the comm.andirg health 
officer. 



Gorce-JJalar. 

We must look to Gambia and Sierra Leone for the seeds 
of the terrible epidemic which decimated Senegal in 1878.^^ 

During the first five months of 1878, the public health 
was excellent throughout Senegal. A Tew cases of dengue 
were observed here and there, but otherwise thf.re were 
no febrile disorders. Yellow fever was in Sierra Leone 
and Gambia and precaution's were taken at Goree to pre- 
vent its importation, but these sanitary measures were un- 
doubtedly elastic, for nine European refugees from a little 
settlement near Bathurst were permitted to land at Goree 
in the beginning of Julj^ and mingle with the population. 
At about the same time, an English vessel arrived at Goree 
from Sierra Leone and was given pratique. 

The criminal imprudence of the authorities In harbor- 
ing these refugees from localities whicli had infected Goree 
again and again in the past, soon bore fruit. On July 11, 
the chief magistrate of the town was taken ill and died on 
the 13th. A few days later, other case^' were observed, one 
terminating in death at the hospital on July 22. Another 
death occurred on the 24th, one on the 26th and three on 
the 27th. The state of affairs w^as well-known to the 
authorities, who were day by day informed of the progress 

°' In compiling the history of this memorable epidemic, we 
have consulted the writings of the following eminent 
French writers: Berenger-Feraud, Lejemble, Duval, 
Dupont, Daril, Forne, Kermorgant, and Vincent. The 
full title of these works will be found in the Bibliography 
at the end of this volume. 



SENEGAL — 1878. 269 

of the outbreak, but the facts were suppressed from the 
general public and it was only on July 30, when it was 
seen tliat the epidemic was getting bevond control, that a 
proclamation announcing the existence of the disease was 
published in the Moniteur Officiel du Senegal. 

Saint-Louis was thrown into a panic. Strict quarantine 
was maintained against Goree and the pest was temjDora- 
rily kept away from its doors. 

The epidemic made rapid progress at Goree and soon 
spread to its suburb, Dakar, At the end of July, the bar- 
racks were evacuated, as a sanitary jirecaution, and the 
soleliers dispersed to minor posts of the colony, being quar- 
tered at Hann, M-Bidgen, Bel-Air and Thies. But this 
exoelus did not stop the ravages of the disease Between 
the 1st and 15th of August, 80 deaihs occurred at Goree- 
Dakar ; between the 15th and 30th, 20. The epidemic then 
seemed to be on the wane, for only 12 deaths occurred in 
the months of September and October. Only one death 
took place from September 28 to October 28, and the epi- 
demic was thought to be ended, whei' some ne^\ arrivals 
rekindled the spark of contagion and we fir.d a record of 
3 deaths on October 29th and 4 on December 9th. 

The population of Goree-Dakar in 1878 was about 3243, 
of which 120 were Europeans. When ^he epidemic broke 
out, 21 fled to Europe, leaving a white population of 99. 
Out of this number, there were 88 deaths, 

Saint- IjQiiit; 

Saint-Louis remained uncontaminat:d u^itil September 
6, when the elisijatch boat Esparlon arrived from Bakel 
and was alloweel free communication with the inliabitants 
of the town. On September 9, the ship's surgeon was 
taken ill with "bilious fever-' and transported to the mili- 
tary hospital, Avhere he died on the 13* h, with unmistak- 
able symptoms of yellow fever. 

The invasion would in all probability have been con- 
fined to this case, for Saint-Louis had up to that date suc- 
cessfully baffled the pestilence which Avas at its very doors, 
had it not been for an unpardonable imprudence on the 
part of the health authorities, caused by over-confidence 



270 HISTORY OF YELLOW FEVSR. 

and commercialism. On September 29, the dispatch boat 
Cygne. which had taken part in the expedition against the 
natives of the Upper Senegal, returi ed to Saint-Louis, 
having on board 51 wounded, of which 17 were Europeans. 
The Cygne was permitted to land her passengers unmo- 
lested, although it was known that the vessel came from 
an infected territory. The soldiers returned to their 
homes and mingled freely with the population. In a few 
days, the poison began to diffuse itself through the town 
and the first death from yellow fever occurred on October 
6. The next day, another case terminated fatally. Other 
cases followed rapidly, proving fatal in almost every in- 
stance. On Octobsr 8, the disease w^as widespread. In 
spite of this deplorable state of affairs, the authorities 
strenuously denied all knowledge of the existence of yellow 
fever in the town, even after eight fatalities had taken 
place between the 9th and 15th of October. About that 
date, although still refusing to admit that the epidemic 
was one of yellow fever, the administ. jttion began sending 
the sick and the ''susj)icious cases" to an improvised lazar- 
etto at the Pointe-aux-Chameaux, a short listance from 
Saint-Louis. 

The truth of the presence of the terrible disease in their 
midst soon became too apparent to be discountenanced 
and the stolid optimism of the little irroup of Europeans 
suddenly gave place to panic and despair. A rumor was 
circulated that all the cases transported to Pointe-aux- 
Chameaux died as soon as they reached the lazeretto and 
the 'families of the '^suspicious cases" soon began to con- 
sider an order for the transportation of a beloved one 
equivalent to a burial permit. 

Lejemble graphically describes the way in which the 
unfortunates were transferred to the lazaretto. Every 
morning, about nine o'clock, the patrol would make its 
rounds and anyone found with fever, oi' even ^'suspicious," 
was taken in tow. It was a gruesome sight to see these 
wretches dragging their ways through the streets of the 
town, some clad only in the blanket which had covered 
them on the sick-bed, some so weak that they had to be 
propped up and helped along by the native health-guards. 
But the people, dazed by the terrible havsc which was 



SENEGAL. 1878. 271 

going- on in their midst, looked on \vith sullen indifference 
at the spectacle of their relatives or comrades being driven 
like cattle to the water's edge, where tiioy would be packed 
into a small boat hardly able to contain half their num- 
bers and roAved by blacks for two weary hours, under a 
blazing tropical sun, to the pest-hovse at the PoJnte-aux- 
Chameaux. No wonder that they were either dead or mori- 
bund vrhen they reached their destination. And tlie terror 
which the simple word '^Lazaretto" caused the people was 
certainly well-founded, for out of about 150 yellow fever 
patients transported from Saint-Louis to the Pointe-aux- 
Chameaux between October 15 and "^ovember 17, there 
were 108 fatalities. 

If the mortality at the Pointe-aux-Chameaux lazaretto 
Avas excessive, other localities, where the soldiers w^ere sent 
by the authorities in a frantic endeavor to stop the ravages 
of the disease, suffered as much. At O'Niaga^ Lampsar, 
N'Dialakkar, Bel-Air, Cape Manuel, Hann, M'Bidgen, 
Thies, and other posts, we find the same terrible record of 
fatalities. 

The fatalities in Saint-Louis, when ihe last death took 
place (December 17), amounted to 30 among the civil 
population (Europeans) and 39 soldiers. 

The Disastrous Logo Hxp^dition 

While the epidemic was raging at Goree, the French 
government ordered that a punitive foice be sent to Logo, 
a district northeast of Sierra Leone, +j avenge some fan- 
cied wrong committed by the natives. The chief health 
officer of Saint-Louis, the starting point of the expedition, 
sent a vigorous protest against such a measure, urging 
as the principal reason the unsanitary condition of the 
country, the fact that yellow^ fever was raging ^^up the 
river," and the distance of the territory to be invaded; but 
his protestations were unheeded. On September 11, a few 
days before the fever broke out in Saint Louis, the troops 
were embarked on the dispatch boats Ara?;e^ Cygne and 
Espadon. The expedition consisted of 535 men, 317 
Europeans and 218 native soldiers. The Lealt;! of the 
column was perfect. 



272 HISTORY OF YELLOW FEVER. 

The first cases on board the fiotilla took place in the 
vicinity of Dagana and Podor and the first death occurred 
at Bakel, in French Soudan ( q. y. ) , on September 15, four 
days after leaving Saint-Louis. Previous to the arrival 
of the vessels at Bakel, where the garrison consisted of 
only eight Europeans, there had been seven deaths from 
yellow fever in the village between August 16 and Septem- 
ber 11. Including the case which teri^dnated fatally on 
September 15, and which was imported by the expedition, 
there were altogether 17 deaths at Bt^kel between August 
16 and October 27. Nine of these denths resulted from 
cases landed from the Arahc and Espaclon. 

Yellow fever was also prevailing at Salde, a small post 
on the Upper Senegal Eiver^ which hac been contaminated 
by Bakel, for some time previous to the arrival of the fleet. 
A death occurred on August 22d, one on the 26th, and a 
third on September 5th. After the ^'battle" of Saboucire, 
the soldiers stopped at Salde on their w ay to Samt-Louis 
and we find a record of three deaths on October 3 and one 
on October 11, making a total of nine deaths between 
August 22 and October 11. 

The ^'battle'' of Saboucire took place on September 22 
and lasted four hours, withoiit accoujplishing anything 
decisive. The column immediately bfr^gan its journey 
homeward. For ten days the expedition slowly wended its 
way down the Senegal Kiver, harassed by disease and 
fatigue. Unable to proceed further, owing to the wide- 
spread prevalence of fever in their ranks, a portion of the 
retreating column halted at Dagana, while the balance 
13roceeded as far as Kichard-Toll; whe?e further progi'ess 
was found impossible. The intensity cf the fever which 
was decimating the soldiers is proved Dy the fact that 113 
were buried at Dogana and 22 at Richard-Toll. 

It will be seen that the ill-advise J Logo expedition acted 
like a firebrand in spreading the pestilence. Post after 
post was infected during its funereal march and when the 
remnants of the column finally reached Saint-Louis, after 
having ^'punished" the savages in a manner which reflected 
doubtful honor upon the French arms, yellow fever had 
claimed one hundred and seventv-six v'jctims. 



SENEGAL — 1878. 273 

Statistics of the Senegal Epidcinic of 18' 



* c. 



The yellow fever epidemic of 1878 ia Senegal, which be- 
gan at Goree-Dakar on July 11 and ended at Saint-Louis 
on December 17, resulted in 749 death..-. TLis figure only 
represents the fatalities among the white population, con- 
sisting of 274 civilians and 1200 soldiers. The course of 
the disease among the blacks, who, in nearly every in- 
stance, proved immune to yellow fever during epidemics in 
Senegal, is lightly touched upon hj the numerous authors 
we have consulted and the natural inference is that the 
natives must either have totally escaped or suffered so 
little, that it was not thought worth while to go into de- 
tails.. 

The mortality among the whites was as f ollov/« : 
Arrondissement of Goree (Goree-Dakar and neigh- 

moring villages ) , , . . 373 

Logo Expedition 176 

Arrondissement of Saint-Louis (Saint-Louis, Pointe- 

aux-Chameaux and neighboring villages) .... . . 200 



Total deaths 749 

1879. 
Dag ana. 

A single case of yellow fever manifested Itself in Sene- 
gal in 1879, at Dagana, in the person of an army officer. 
The patient recovered.^^ 

1880. 
Saint-Louis. 

In March, 1880, sporadic cases of yellow fever were ob- 
served in a small house adjoining the barracks at Saint- 
Louis, occupied by tailors attached to the regiment. Sani- 
tary measures were at once taken and the disease restrict- 

^Noury: Gazette Medicale de Nantes, 1884, vol. 2, p. 85. 



274 HISTORY OF YELLOW FEVER. 

ed to its original site. The gensis of this outbreak has 
never been clearly elucidated. Bereni^er-Feraud^^ notes 
the fact that the tailors had been occupied in remodeling 
cloth garments which had been stored since the great epi- 
demic of 1878, and attributes the infection to this fact. But 
this theory can hardly be seriously entertained. The epi- 
demic of 1878 came to an end on Drcei^iber J 7 of that year 
and the outbreak under discussion took place in March, 
1880.. It will therefore be seen that the veteran Htegomyia 
Calopae of 1878 must have been endowed with phenome- 
nal poAvers of endurance to hibernate for fifteen months in 
a lot of old garments and then be possessed with sufficient 
pugnacity and vigor to introduce the poison into the 
systems of the unfortunate wielders ol the net^dle and 
thread. 

That the health authorities of Sairt-Louis believed in 
the theory promulgated by Berenger-P'-^raud; was proved 
by the fact that the offending garments were ordered to 
be incinerated and the vestment makers were put under 
strict surveillance. The outbreak wa< stamped out at 
once and the public health continued to be excellent 
throughout the winter. In the beginning «)f November, 
hoAvever, the fever again broke out in tlie infantry barracks 
of the garrison of Saint-Louis and lasted until the begin- 
ning of 1881, resulting in eighty death>'. The cause of this 
second outbreak has never been luridlj explained. 

ISSl. 
Saint-Louis. 

The year 1881 witnessed another terrible epitlemic of 
yellow fever in Senegal. We are indebted to Berenger- 
Feraud, Duval, de Boisse, Noury and Esclagon for the 
facts.-^<5 

;The first case Avas obserA^ed on June 26, in a soldier at- 
tached to the marine infantry of Saint-Louis, who Avas ad- 

^^ Berenger-Feraud, p. 169. 

=« Berenger-Feraud, loc. cit, p. 170; Duval, loc. cit, p, 24; de 
Boisse: Theses de Paris, 1884, No. 52; Noury: Gazette 
Medicale de Nantes, 1884, vol. 2, pp. 84; 103; Esclagon; 
Theses de Paris, 1883. 



SENEGAL — 1881. 275 

mitted into the hospital on the 27th, and died July 2d. On 
July 20, another soldier entered the hospital and died on 
the 23d, with unmistakable symptoms of yellow fever. 

In the interval between these two e:ises, three others, 
folloAved by death, had broken out in different sections of 
the town — one on July 5th, which proved fatal on the 10th ; 
one death on the 14th and another on the 15th. 

On July 23, several cases suddenly manifested them- 
selves all over the city and at the barracks. From that 
date, the epidemic had full sway and Ir.sted until Septem- 
ber 26th. Out of a population of 1,000 Europeans, there 
resulted 521 cases and 425 deaths. 

Malcana. 

On July 25th and 28th, 108 soldieis were transferred 
from Saint-Louis to Makana, a village Dear Lampsar. Al- 
most Immediately after their arrival, eight men were 
stricken with fever and died in a day or two after the onset 
of the disease. A ninth case manifested itself and died 
August 14th. On the 20th another case occurred, followed 
by death on the 23d. This concluded the outbreak at 
Makana. Xo cases originated in the village, the attacks 
being confined to persons wiio had recently arrived from 
Saint-Louis. This probably saved the balance of the 
refugees, for every attack resulted in death. 

Pointe-aux-Cliameaiix. 

Ninety-three soldiers were sent fr^jm Saint-Louis to 
Pointe-aux-Chameaux ; 92 to N'Diago and 83 to Kichard- 
Toll. Not a single case occurred at any of these posts. 

Bop-Diarra. 

On July 30th, 215 men from the Saint-Louis barracks 
were transported to Bop-Diara. From that date to Sep- 
tember 10th, 21 cases and 13 deaths were recorded in the 
three camps improvised at this post. 



'2.0 HISTORY OF YELLOW FEVER, 

Goree-Dal'ur. 

The Castor plaTecl a more nnfcrtiiiiate role in tlie chain 
of infection than any other ressel in llie T^aters of the 
Seneoial, for it transmitted the dt«ea?c to Gorte-Dakar, 
which had remained uncontaminatod T\'hil? the ]>esti]ence 
was being carried in everr direction by refugees from 
Saint-Louis and other infected i)osts. The Castor will be 
remembered as one of the dispatcli-boats which lielped in 
the transi^ortation of the Logo Expedition of 1S7S and 
which furnished its quota of vir-tims in rhe memorable 
epidemic of that year.^' 

In the beginning of the epidemic of ISSl, a case of yel- 
low fever had been bruught from the Castor to the military 
hospital at Saint Louis. The yessel was then sent on a 
mission to the CajDe Verd Islands, with the hope that the 
trip would proTe sanitary and prevent further ertiptions. 
Xo further cases occurred. "^Alien the vessel returned to 
Saiut-Lotiis. it was learned that the disease had assumed 
grave proportions in the town and she was ordered to 
Goree. The crew continued healthy and Goree was con- 
gratulating itself upon having kept the pestileuce away 
from its doors, when the commandant of the Castor was 
taken seriotisly ill. On the pretext that it was simj)ly mal- 
aria, for if yellow fever had been mentioned the patient 
would have been turned away, the case was admitted into 
the hospital at Goree. The patient died on September 5th. 
The attending physician. Dr. Cari^entiu, who had seen the 
disease at Guadelottpe. unhesitatingly pronounced it 
yellow fever, but refrained from giving publicity to the 
fact, fearing a panic and thinking no other cases wotild 
ensue. A day or so after the death of the officer, a work- 
man on board the Castor was taken V] and died in a few 
days. The news of this second case roused the health 
authorities from their lethargy an<l the vessel vras put 
under strict quarantine and sent to Bel -Air. Ou Septem- 
ber 12. another yellow fever death t- :ok place on the Castor. 
The crew was transported to tents on shore and the vessel 
thoroughly fumigated. The crew was then re-i mbarked, 

^' See account of the Senegal epidemic of 1S7S in this volume. 



SENEGAL 1881. 277 

as the accommodations on shore were miserably deficient. 
The health of the sailors continuing To be bad, the vessel 
was ordered to France. 

But the evil was already beyond redemption. The germs 
of infection created by the admission of the commandant 
of the Castor at the Goree military hospital, though slow 
to manifest themselYes, finally gave evidence of their 
virility. Two phj^sicians attached to the hospital w^ere 
successively^ attacked, one of the crises resulting in death. 
Dr. Carpentin's secretary was the next victim. The doc- 
tor himself contracted the disease and died and the young 
man who had succeeded the first secretary shared the 
same fate. The disease seemed to be confined tc. the hos- 
pital, when a Sister of Charity attached to the parochial 
school was suddenl}^ stricken, dying shortly afterwards. 
After this, sporadic cases were observed here and there 
throughout the city. 

The disease was at no time virulent at Goree-Dakar. 
There were altogether 16 deaths. 

The Fever on the Qovernmevt Yessels. 

While the epidemic was raging at Saint-Louis, five gov- 
ernment vessels were moored at the w^hjirves, namely : The 
Jaguar, the Alecton, the Afi^ican, the Cijgne and the 
Eciireuil. 

The dispatch-boat VAfricain. an ^'old tub," and at the 
time seldom in active service, had a ciew" of forty whites 
at the inception of the epidemic. Jt was anchored, or 
rather tied, to the Avharf at Saint-Louis and was used as 
a sort of floating w^orkshop by the roilitary authorities. 
It w-as in continuous communication with the shore. On 
July 26th, the first case of yellow fever w^as observed on 
board, followed shortly after by six others. On August 
12th, the old hulk was taken in tow^ by VEcurmiil and 
brought to Mouit, w^here her crew was transported to im- 
provised tent-hospitals on shore, a short distance from 
those occupied by the sick from the Jaguar , On August 
16, a new case developed in the camp, ^and from July 26, 
the date of the first case, until October, ihere were 33 cases 
and 23 deaths. 



278 HISTORY OF YELLOW FEVER. 

The Jaguar, an old wooden gunbo-iit, illj-constructed 
and badly ventilated, and which had uninterrupted com- 
munication with Saint-Louis, had a crew of 60 whites and 
25 blacks.^^ On July 29, the first case broke out on board, 
followed on the 31st by six others. August 1st, another 
case. The vessel was ordered down the river to Mouit, 
where three large tents were constructed for th*^ accom- 
modation of the sick and other members of the crew. In 
spite of these precautions, up to the fii.st dajs of October, 
43 new cases developed in the improvi;?ed hospitals. Total 
cases, 51; deaths, 23. 

The Gygne was in dock when the epidemic .began. On 
August 4, the repairs being completed, the vessel was 
again iDlaced in commission with a crew of 21 whites and 
24 blacks, and anchored at the same place where the 
Jaguar had been when the fever first manifested itself on 
board, where it remained four days. On August 8, the ves- 
sel left its moorings and anchored in the middle of the 
river. On the 9th, four members of the crew were taken 
ill with fever, but recovered after only three days' illness. 
These four cases presented/ no symptoms whatever of yel- 
low fever, but on the 13th, two other members of the crew 
were taken ill, presenting totally different symptoms, and 
were sent to the hospital. One of the cases recovered after 
a brief illness, but the other proved to be a typical case of 
yellow fever and died three days after the onset. The 
Cygne left KSaint-Louis on August 16 for Bop-Diarra, hav- 
ing in tow a barge containing a large number of patients 
destined for the hospital at that point. On September 26, 
the Cygne, which in the interval had made several voyages 
from the Point-aux-Chameaux to Saint-Louis, returned 
to her anchorage at the latter town. Being the only vessel 
then available, it was immediately pressed into service and 
sent up the river Avith a tow of barges containing pro- 
visions and medicines for the yellow fever sufferers. It 
was soon discovered that the machinery of the Cygne was 
not strong enough for such a heavy tow, but the necessity 

'^^All vessels plying in the waters of the Senegal River are 
equipped with native sailors, who do most of the out- 
door work, as the whites cannot stand the fierce rays of 
the tropical sun. 



SENEGAL 1881. 279 

being urgent, the cargo was transported on board the ves- 
sel, Avhich proceeded on its mission. The voyage came to 
an end on October 8 and the vessel returned to Saint-Louis 
October 17, where two white army officers from Bop- 
Diarra, where yellow fever Avas still present, and one hun- 
dred negro workmen from Saint-Louis, were embarked, 
destined for work on the railroad in course of construction 
up the Senegal Kiver. During the voyage, which lasted 
until October 30, not a single case of yellow fever was ob- 
served on board the vessel. On its return to Saint-Louis, 
forty Africans and fifty Moroccans Avere sent on board 
and ordered transported to the railroad camps up the 
river. The Moroccans, aa ho originally numbered 150, had 
lost one-third of their fellow-men b}^ yelloAV fever at Saint- 
Louis. The A^oyage was uneventful and AA'hen the Cijgne 
returned to the capital, the epidemic had almost died out. 
The last death in town took place on NoA^ember 20th and 
quarantine Avas raised December 10th. 

We have giA^en a full account of the transactions in 
AA^hich the Cygne participated, because the vessel shoAved 
a remarkable freedom from infection. Out of 21 Euro- 
peans on board, only one attack, folloAved by death, took 
place, although the vessel was actiA^ely engaged in trans- 
porting the sick and the pestilence Avas raging all around 
her. The fact that the vessel was fresh from the dock, 
where she had been thoroughly OA^erhauled and repaired, 
probably saA^ed her from an iuA^asion of the Stegomyia 
Calopus, and to this must we attribute her immunity 
after the first case, which had CAddently been imported. 

The Alecton, a dispatch-boat employed in the coast ser- 
vice, Avas at Dakar when the epidemic broke out at Saint- 
Louis. She was forbidden communication Avitli the in- 
fected town. About the end of August, she left Dakar and 
sailed up the Senegal EiA^er, anchoring a short distance 
below Saint-Louis, to the Avindward of two merchant-ves^ 
sels, the General Berge and the Gabrielle. There had been 
yelloAv fever cases on board both these vessels, but the fact 
had been Avithheld from the authorities and the little dis- 
patch-boat remained for a Aveek in the Adcinity of the ships, 
unsuspicious of danger. On September 9, she was sent to 
the Cape Verd Islands with a dispatch from the Governor 



280 HISTORY OF YELLOW FEVER. 

of the colon}^ While enroute to the islands, suspicious 
cases began to show themselves among the officers and the 
vessel was sent to the Saint Vincent Island quarantine sta- 
tion on her arrival at the Cape Verds, but only remained 
there a few hours, her captain preferring the open sea. 
On September 14, on the return voyage to Saint-Louis, the 
first death took place, followed the next day by two others. 
On the 17th, the vessel re-entered the Senegal River and 
the crew was disembarked and placed in a tent on Baba- 
guay Island, where the last death took place on October 1. 
There were altogether 15 cases and 8 deaths. 

The Ecureuil, a new vessel, with a crew of 40 whites and 
25 blacks, arrived at Saint-Louis on the same day that the 
epidemic broke out. Her officers and crew had uninter- 
rupted communication with the town, and, being the only 
available vessel for the purpose at the time, it was used 
to transport the troops to the several towns up and down 
the Senegal River. No ill effects were observed on board 
until August 14th, when the cook and the mess-boy pre- 
sented characteristic symptoms of yellow fever and were 
transported to the military hospital at Saint-Louis, where 
they died in a few days. On August 15, the Ecureuil was 
sent on a mission up the Senegal and during a cruise last- 
ing a little over a month, no other cases developed. About 
the end of September, the vessel returned to Saint-Louis, 
but profiting by past experience, it did not anchor opposite 
the town, but proceeded to the Pointe-aux-Chameaux, 
where it remained until the end of the epidemic. 



Statistics of the Epidemic. 

The total mortality from yellow fever among the Euro- 
pean population during the epidemic of 1881 has been esti- 
mated at 700 (Duval). We could only get statistics of 
transactions at the principal places of the colony. No- 
where do we find a word about the progress of the malady 
among the natives. The following recapitulation will give 
an idea of the malignity of the outbreak : 



SENEGAL. 281 

Locality. White Population. Cases. Deaths. 

Saiut-Louis 1,000 524 425 

Bop-Diarra 215 21 13 

Makana 108 10 10 

Goree-Dakar 16 . 14 

Unclassified , ... 362 181 

On vessels : 



Jaguar 60 51 23 

L'AMcain 40 33 23 

Alecton 47 15 8 

L'Ecureuil 40 2 2 

Le Cvgne 21 1 1 



1035 700 

The number of ^^unclassified'' cases (362) is estimated 
on a mortality of fifty per cent., based upon the excessive 
death-Tate at every locality where the disease prevailed. 
For example, Saint-Louis, with a population of 1,000 
Europeans, had 524 cases and 425 deaths; Makana had a 
mortality of one hundred per cent. ; the gunboat Jaguar, 
with a crew of 60, had 51 cases and 23 deaths. The "un- 
classified" mortality being 181, we believe that the cases 
were certainly not over double that number; they were 
probably less. 

The soldiers, as usual, paid a heavy tax to the pestil- 
ence. The following figures speak for themselves : 

Total number of soldiers in the colony, 559. 

Number attacked, 246, or 44 per cent. 

Deaths, 216, or 81.7 per cent, of the number attacked. 

Forty-five officers succumbed. 

' 1882. 

Goree. 

The epidemic of 1882 does not appear to have been im- 
ported, but to have been of spontaneous origin. The de- 



282 HISTORY OF YELLOW FEVER. 

molition of the old military hospital at Goree is given as 
oue of the causes. This work was to have been done dur- 
ing the winter, but, for some cause or other, was delayed 
until June. It is natural to infer that the razing of this 
old pest-house should liberate thousands of mosquitoes 
and that these insects, still impregnated with the virus of 
the epidemic of the year before, should engender another 
outbreak of a disease which has been the executioner of 
the unfortunate European residents of Senegal for nearly 
two centuries. 

The first case manifested iteslf on June 12, in the per- 
son of Dr. Duval, one of the heakh officers of the colony, 
who wrote an elaborate history of his illness and to whom 
we are indebted for the facts of the rise and progTess of 
the epidemic.''^ 

It seems that, while the workmen were engaged in tear- 
ing down the old building, Dr. Duval moved his office to 
a room which had in former years been occupied by the 
municipal board of health. Owing to the warm weather, 
the windows were kept open during the business hours, 
thus allowing full ingress to the dust and mosquitoes from 
the falling timbers. The doctor states that he began feel- 
ing ill about June 12, but did not take to bed before the 
15th. He gives a detailed account of the attack, which 
was a typical case of mild yellow fever. He was confined 
to his room for eleven days and made an uneventful re- 
covery. 

Xo other case was observed until July 7, when a wash- 
erwoman employed in the barracks was taken ill, dying on 
the 12th. On Jtily 8, a merchant was stricken, recovering 
after an illness of thirtv-four davs. The fourth case, July 
9 (a clerk), recovered. 

The four sporadic cases above noted were not made pub- 
lic by the authorities. 

On July 24, the number of cases became so numerous, 
that the fever was declared officially present, and active 
sanitary measures were put into execution. On July 26, 
the other posts in Senegal quarantined against Goree. 

When the fever was declared epidemic, there were 1,800 
blacks and abotit 67 whites at Goree. Of these 67, there 

=^'-' Duval: La Fievre Jaune a Goree (Bordeaux, 1883), p. 94. 



-SENEGAL — 1888. 283 

were 37 who had already suffered an attack of yellow 
fever in previous epidemics, thus leaving 30 susceptible to 
infection. The virulence of the epidemic was certainly 
notable, for of this small number, 27 were attacked and 
15 died. The last case manifested itself on September 17 ; 
the last death occurred September 22d. 

The epidemic of 1882 gave rise to much discussion 
among the French medical men. Some claimed it was 
imported from Brazil, others from Gambia, while the ma- 
jority (among whom we notice Duval and Berenger- 
Feraud) insist that it originated at Goree. We think the 
last hypothesis correct, as there was no yellow fever in 
Gambia in 1882 and no suspicious vessels from Brazil 
were observed in the waters of the Senegal that year. The 
demolition of the old military hospital probably hastened 
the outbreak, but the infected Stegomyia would no doubt; 
eventually have ventured into the open and diffused the 
poison among the susceptibles. 

Dakar, 

Dakar, a suburb of Goree, separated from the town by an 
arm of the Atlantic Ocean, observed a strict quarantine, 
but the harbormaster of the village went on a secret visit 
to Goree about the end of August and was stricken with 
yellow fever a few days after his return home. This im.- 
prudence cost him his life. 

No other cases were noticed in Dakar until the middle 
of NoA'ember, when the quartermaster of the dispatcli- 
boat Albatross, then anchored opposite Dakar, died at the 
hospital under circumstances which strong!}^ pointed to 
yellow fever infection. A soldier at the barracks was the 
next victim. A panic ensued when the news of these two 
deaths became known and eight white men engaged in rail- 
road work fled to Yof, some distance from Dakar, where 
the fever broke out among them. Concluding that they 
would receive better medical attention at Dakar, they re- 
turned to the village, where three of their number died. 
The fever pursued an erratic course at Dakar and finally 
came to an end on December 22. There were altogether 40 
cases and 30 deaths. 



284 HISTORY OF YELLOW FEVER. 

Rufisque. 

Eufisqiie, also located on the continent, opposite Goree, 
furnished two cases, one on August 10, followed by re- 
covery, and the other in the beginning of September, re- 
sulting in death. The source of infection is not given, but 
the natural inference is to incriminate Goree. 

0)1 the Albatross. 

The dispatch-boat Albatross^ newlj-built and fresh from 
France, arrived at Saint-Louis, September 19, 1882. It 
had a crew of 52 whites, which was increased to 80 by th^ 
addition of 28 blacks upon reaching the capital. Tho 
quarantine against Goree was raised October 27, 1882. 
The .4 Ihatross, which had in the meantime been employed 
in carrying the mails from Saint-Louis to Dakar, took 
some passengers from Goree for Saint-Louis on the day the 
quarantine was raised. These consisted of whites and 
blacks, who had been in the infected town for some timic 
and who were anxious to return home. On November T, 
the vessel returned to Dakar, with passengers for a ves- 
sel then about to sail for France. On the way to Dakar, 
the Albatross stopped at the Pointe-aux-Ghameaux and 
took some passengers. One of these men had been ill for 
some days and was brought on board in a litter. There 
being no suspicious sickness at the Pointe, no objections 
were raised to the embarkation of the patient, who was 
said to be suffering from malaria. Arrived at Dakar, the 
patient was transported to the hospital, where he died on 
Xovember 13. An autopsy revealed lesions which raised 
some doubts as to the nature of his illness and his com- 
panions were put under surveilance. Xo cases developed 
among them. A few days later, the quartermaster of the 
Albatross was taken ill and transported to the hospital at 
Dakar, where he died shortly afterward. A soldier was 
taken ill at the barracks and died. 

Yellow fever was then officially declared present on the 
Albatross and at the Dakar hospital. The crew of the 
vessel were transported to the lazaretto on Xovember 21. 
Several deaths occurred at the lazaretto. On December 



SENEGAL — 1882. 285 

30, the sailors returned on board the Albatross^ which had 
been thoroughly disinfected. A few days after the return 
of the crew, the new cases developed. This was followed 
by live fatal cases between the 8tli and lltli of January, 
1883. Orders were then received to return to France and 
the vessel arrived at Brest on March 15. 

The course of the disease on board the Albatross was 
very severe. Out of a crew of 52 whites, there resulted 21 
cases and 18 deaths, including two officers. 

A perplexing question now presents itself : Where did 
the Albatross contract the infection? Not at Saint-Louis, 
for not a single case was observed there in 1882; not at 
the Pointe-aux-Chameaux, for the place is said to have 
been remarkably healthy at the time and to have had no 
communication whatsoever with infected localities. These 
two places being disposed of, suspicion naturally falls 
upon the only other locality visited by the unfortunate 
vessel — Dakar. Duval -incriminates the Point-aux-Cham- 
eaux in the infection of the Albatross^ basing his accusa- 
tion on the fact that the first case of fatal illness observed 
on board was that of the passenger from that hamlet. We 
do not believe this was a case of yellow fever at all. The 
fact that none of the other passengers were attacked (ex- 
cept some time afterwards, when the disease had assumed 
epidemiological proportions at Dakar) leads us to believe 
that it was simply an aggravated case of paludism. 

Now, let us see what were the conditions at Dakar. 
Duval himself) (loc. cit., page 40) relates the case of the 
harbormaster of Dakar, who is supposed to have made a 
secret visit to Goree, in spite of the rigid quarantine then 
existing, and who died of yellow fever at Dakar during 
the last days of August. It will be remembered that the 
Albatross was in constant communication with that vil- 
lage from the date of her arrival in Senegal (September 
19), doing service as mail-packet between that place and 
Saint-Louis. The quarantine against Goree was raised 
on October 27. This was followed by an exodus from 
Goree to Saint-Louis, but none of the refugees infected 
Saint-Louis and it is natural to presume that they did not 
carry the contagion on board the Albatross. The first 
case of yellow fever officially observed after the quarantine 



^86 tllSTORY OF YELLOW FEVER. 

against Goree had been raised did not take place on board 
the Albatross^ but originated in the barracks at Dakar 
and it was only after the crew had been transj)orted to the 
lazaretto at Dakar that the disease manifested itself 
among the unfortunate sailors. It is true that the death 
of the quartermaster of the Albatross preceded that of 
the soldier, but the former was oftener on shore than on 
board while at the Tillage wharf and could easily have 
been infected while off duty. We make this exxDlanation 
to escape the charge of inconsistency. 

From the end of August, the date of the fatal illness of 
the harbormaster, to the middle of Xovember, when the 
first death took place among the sailors, is undoubtedly 
a long time betAveen cases, but it must be borne in mind 
that, in 1882, Dakar was peopled principally by negroes, 
with a sprinkling of whites here and there, most of them 
immune throttgh having stiff'ered during previous epi- 
demics, and it was only when non-immtines arrived at the 
village that the Stegomi/iae, infected months i)reviously, 
proved their virility. 

1900. 

The First Prc-Epidemic Cases. 

The demolition of the old miliiary hospital which had 
for years been the disgrace of Goree must have given the 
quiettis to the infected Stegomyiae which had been the 
bane of Senegal since 1878, for not a single case of yellow 
fever was observed in the colony from 1882 to 1900, a 
period of eighteen years. 

The focus of the epidemic of 1900 began at Dakar. On 
April 16, a clerk employed in that village was admitted 
into the Goree hospital, in the last stages of an illness 
diagnosed by the attending physician as "diphtheria.'* He 
died an hour after admission, with black vomit. The 
atitopsy revealed no trace whatever of diphtheria. Stis- 
picious lesions were observed, but as yellow fever had not 
been noticed in the colony for years, no thought was given 
to this malady and a verdict of ^'death from pernicious 
fever" recorded. 



SENEGAL 1900. 287 

Ou April 19, a patient entered the hospital, suffering 
from headache, dizziness and difficulty of speech. He 
gradually became worse and died on the 2Ttli. The 
autopsy revealed unmistakable lesions of yellow fever, but 
the physicians present scouted the idea. One of those who 
participated in the autopsy remarked that, at any other 
time, he would have had no hesitation in pronouncing it 
a case of genuine yellow fever, but that the health of the 
colony and the surrounding country was perfect and he 
joined his confreres in giving a verdict of death from ''in- 
fectious jaundice." 

The first case had already been forgotten and no one 
thought of connecting the two deaths with a common 
cause, although they had occurred at an interval of only 
eleven days and had presented identical pathological 
lesions. 

The third case was admitted into the hospital on April 
30 and died on May 3. 

On May 8, a man and a woman Avere transported to the 
hospital. The first case died the following day ; the second, 
five days later. 

All these cases came from Dakar and in each instance 
presented tyi3ical symptoms of yellow fever. The last two 
deaths awakened a vague suspicion on the part of the 
authorities that the sanitary conditions of Dakar demand- 
ed an investigation, but not wishing to alarm the popula- 
tion, orders were given to proceed vvith great secrecy. Un- 
der such conditions, no. open precautionary steps were 
taken and the slumbering pestilence, untrammeled by pre- 
ventive measures, gathered fresh fuel each day. 

On May 11, a Moroccan, who had left Dakar seven days 
previously, died at Thies, an army post on the railroad, be- 
tween Eufisque and Tivaouane. 

A mulatto girl, aged 4, was taken ill at Dakar about the 
same time and died on the 16th. 

On May 18, the disease was for the first time officially 
admitted, the director of public health giving orders that 
the following be inserted in all bills of health given vessels 
leaving the colony: There exists a feio isolated eases of 
suspicious yelloK fever at Dakar and its vicinity. 



c^f 8 HIST CRY CF \EI1CW FEVER. 

Dakar was declared infected and placed under quar- 
antine. 

The people of Dakar, far from being frightened by this 
official declaration, indignantly denied that such a state 
existed. They claimed that the doctors had blundered; 
that yellow fever, according to the views of the oldest in- 
habitants, had never been known to proceed at such a 
snail's pace, but by leaps and bounds. They claimed that 
the prevailing illness Avas an aggravated type of malaria, 
caused by extensive digging operations at Hann, a neigh- 
boring village. 

The merchants, seeing their trades imperiled, took ad- 
vantage of the trend of public opinion and vigorously pro- 
tested against the institution of rigorous sanitar}^ meas- 
ures. The authorities were hampered, hooted and abused, 
cases were hidden and the way thus paved for an epidemic 
which was destined to ravage nearly every city, town and 
hamlet in Senegal. 

On May 22, the troops stationed at Dakar and Rufisque 
were ordered dispersed along the railroad running between 
Dakar and Saint-Louis, only about four hundred being 
left behind. This was done without consulting the author- 
ities of Dakar, and a storm naturally ensued when the 
news became public. In this connection, it is interesting 
to note that the first cases were all among the civilians, 
the military being attacked only in June, two months after 
the outbreak at Dakar. 

On May 22, two cases broke out among the personnel 
of the railroad company at Dakar, followed the next day 
by a case in the same house where the first victim of the 
epidemic had died (April 16). Two of these cases proved 
fatal. 

The railroad hospital, where the two first cases were 
originally brought, was at once disinfected by the authori- 
ties and ordered closed. 

On May 17, four workmen arrived at Senegal from 
Morocco. Two remained at Dakar, while the other two 
proceeded to Saint-Louis. On May 23, the two who had 
been left behind were taken suddenly ill and transferred 
to the toAvn hospital, where they died on the 28th, with 
undeniable symptoms of yellow fever. 



SENEGAL, 1900. 289 

By a peculiar coincidence, one of the Moroccans was 
taken ill at Saint-Louis on the 23d, the same day his com- 
rades were stricken at Dakar, and died on the 26th. It 
will thus be seen that, notwithstanding the fact that yel- 
low fever had been present at Dakar since April 16th, and 
that communications between that village and Saint-Louis 
was figurativelv unrestrained, the capital was only in- 
fected on May 23. 

May 28, another death at Dakar. 

From that date, the situation seemed to improve. Some 
of the more timid Europeans, however, left the colony, 
but the majority, thinking the outbreak was at an end, 
concluded there was no danger and laughed at the fears 
of their less courageous countrymen. 

Recrudescence at Dakar. 

The slow progress of the disease is one of the most re- 
markable features of this epidemic and can only be ac- 
counted for by the fact that the Calopae had not yet be- 
come active, the weather being still a little too cool to per- 
mit them to freely circulate among the population. 

From May 28th to June 7th, no cases were observed. 
Lulled into a false sense of security by this subsidence of 
the disease, the quarantine against Dakar was raised. 

From April 16 to May 28, there had been 14 cases and 
11 deaths. This is what Dr. Kermorgant terms the ''first, 
or pre-epidemic period." The progress of the epidemic 
under discussion showed the identical characteristics 
which has attended nearly every outbreak of yellow fever 
in Senegal : First, a few cases, followed at long intervals 
by others. The disease then seemed to advance by gusts, 
each time more serious and less removed, until its viru- 
lence finally asserted itself and each day brought a case 
or two or a death. 

Up to June 8, the mortality had been 78.6 per cent. On 
that day, a sergeant of infantry stationed at Camp INTade- 
leine No. 2, near Dakar, was stricken and died on the 10th. 
Before dying, this officer admitted that he had evaded the 
quarantine regulations and had slept at Dakar on several 
occasions. 



290 HISTORY OF YELLOW FKVER. 

June 9. The bishop of Saint-Louis, while making pas- 
toral calls at Dakar and Kufisque, was taken suddenly ill 
and died on the 13th. 

June 10. A clerk at Dakar succumbed, after a brief 
illness. 

June 11. Two sisters of charity, one of whom had 
nursed the bishop, were stricken. 

On June 10, Dakar was again quarantined. A military 
sanitary cordon was placed around Cape Verd peninsula 
and the terminus of the railroad moved to Eufisque. The 
authorities had at last awakened to the seriousness of the 
situation; but it was a sad analogy of the trite expedient 
of locking the stable after the horse had been stolen — the 
germs of pestilence were already too widely disseminated 
and no preventive measures under heaven could check the 
march of the saffron scourge. 

The mass of the people, still unconvinced, looked upon 
these acts as an uncalled for usurpation of power and 
continued to clandestinely visit the nidus of infection. 

June 15, two new cases at Dakar, followed by one death. 

On June 27, a new case at Dakar, followed by another 
on the 29th. The first case died on the 30th, the second 
on July 1. 

There had been no new cases since June 15. 

From that date, the epidemic had full sway. Every 
place in Senegal became suspicious of its neighbor. Local 
quarantines were established, every town and hamlet inter- 
dicting communication with the other. The panic reached 
such an acute stage, that armed guards were stationed 
everywhere and natives who attempted to get within the 
lines were shot down like dogs. 

Panic and Flight. 

It was only towards the end of June that the European 
population of Goree, Saint-Louis and other towns of Sene- 
gal began to realize that something unusual was taking 
place in the health conditions of the colony. The peo- 
ple awoke, as if from a dream, to find itself facing what 
seemed inevitable death. All the horrors of previous epi- 
demics were suddenly brought to mind. Indifference to 



SENEGAL, 1£00. 291 

existing conditions gave way to consternation and panic. 
The physicians were no longer hooted or ridiculed, but 
were besieged for advice as to the best preventive methods 
to follow. Hundreds sold their belongings and sought se- 
curity in flight. The passenger steamers leaving for 
Europe were taxed to their utmost capacity and when the 
large mail steamers, fearing to contaminate their crews, 
refused to take passengers, the refugees were only too glad 
to escape by means of the filthy coasting vessels, which 
took them to ports where quarantines were not in force, 
whence they proceeded by roundabout ways to Europe. 
Some even took passage on vessels bound for South Ameri- 
can ports, trusting to luck to meet some European-bound 
vessels on the high-seas. The official journals^ of Senegal, 
in their accounts of this wholesale exodus, state that near- 
ly 3,000 persons left the .colony between June and Sep- 
tember. 

The following tableau of departure from Senegal by 
ocean steamers from July 1 to August 16, gives an idea 
of the eagerness of the people to flee from, this plague spot 
of Western Africa : 

Passengers. 

July 1. By steamer Faidherhe 15 

July 1. By steamer Yauban 160 

July 12. By steamer Yille de Pernamhu^jo .... 82 

July 26. By steamer Caravellas 435 

July 27. By steamer Saiita Fe 223 

Aug. 13. By steamers Ville de Maceio and 

Macina 278 

Aug. 16.. By steamers Richelieu and Campana 473 

Total • 1.666 

In addition to the above total, must be included the 
departures prior to July 1st, and the exodus by the coast- 
ing vessels and other French and English vessels, of which 
no record was kept by the port authorities. 

That the fears of the owners of these passenger steamers 
were well grounded, was exemplified by the fact that cases 
occurred on many of these vessels. The disease did not 
spread, however, being confined to the original cases. 



292 HISTORY OF YELLOW FEVER. 

The disease was even brought to the lazaretto- at Paulliac, 
France, where several eases were treated without creating 
any focus. 

Even Paris — careless, wicked, fun-loving Paris — was 
wrought to fever heat at the policy of concealment pur- 
sued by the colonial authorities. The government had sent 
2,000 young soldiers a few months previous to Senegal, 
to 'Opacify" the natives in the interior, and the public 
wanted to know why their countrymen were sent to this 
barbarous region to die like rats, alleging that these 
dependencies, whose only products were pestilences and 
murderous negroes, were not worth keeping. The Paris 
Soleil, in commenting on the epidemic, thus concludes an 
inspired article : 

^Thysicians die like flies. Sisters and infirmarians fol- 
low the same road. Mass is no longer said in public on 
account of contagion. Fortunately, there will always re- 
main a negro priest to absolve the last who die, for it is a 
curious fact that the negroes are completely immune." 

Consul Strickland, the representative of the United 
States, at Senegal, from whose reports some of the details 
of the inception of this epidemic are taken,^^ gives giraphic 
pen-pictures of the scenes at Goree-Dakar and Saint Louis. 
"The epidemic has brought the business of the colony com- 
pletely to a standstill," he observes, "and all Europeans 
have got away, who could command the means to do so. 
The stores are shut, and it is dififlcult to obtain the neces- 
saries of life." 

Consul Strickland sailed from Senegal during the last 
days of July, 1900, and the United States Consular reports 
give no details of the progress of the epidemic after that 
date. We are indebted to the exhaustive accounts pub- 
lished by Dr. Kermorgant in the Annales d'Eygiene et de 
Medecine Coloniales and the Recueil des Tra^aux de 
Comite Consultatif d^ Hygiene Publique de France ^ for 
most of the facts which precede and follow.^^ 

""Strickland: U. S. Public Health Reports, 1900, vol. 25, pp. 

1679; 1866; 2025; 2188. 
*^ Annales d'Hygiene, etc., vol. 4. pp. 325, et seq.; Recueil, 
etc., Paris, 1903, vol 31, pp.. 369, et seq. 



SENEGAL, 1900. 293 

MARCH OF THE EPIDEMIC. 
Dakar. 

As already noted, the true epidemic epoch may be said 
to have manifested itself with the series of cases and 
deaths at the end of June, 1900. On July 4th, 5th and 
6th, cases cropped out everywhere, and it was a question 
of saiive qui pent. The authorities resorted to the tardy 
expedient of sending the Avhite troops back to Europe, and 
replacing them with native soldiers. 

From the 1st to the 31st of July, there were sixty cases 
and thirty- one deaths, at Dakar. 

The exodus of a majority of the white population does 
not seem to have done much toward arresting the progress 
of the pest, for twenty-nine cases Avere admitted into the 
hospital, in August. Of these, four cases came from Saint 
Louis and Thies, and five were taken f'rom the steamships 
General Dodds and Yauban. The nine importations, there- 
fore, leaves the actual number for Dakar at twenty. 

The epidemic gradually subsided, for want of material, 
in September, nine cases and four deaths being recorded 
for that month. 

October, three deaths. 

The epidemic finally came to an end in November, with 
two cases and one death, making a grand total for Dakar, 
from April 16, to November, of one hundred and f orty-two' 
cases and seventy-six deaths. 

GOREE. 

Goree quarantined against Dakar, May 27th, 1900, but 
not much attention was paid to the mandate, communica- 
tion between the two localities being almost uninterrupted. 

This lack of precautions soon bore fruit. A soldier of 
infantry, who had been given a furlough, celebrated the 
event by making a round of the barrooms of Dakar, on 
Sunday, June 17th, and returned to camp in a beastly 
state of intoxication. On the 20th, he was sent to the 
hospital, where he died with black vomit, on the 23rd. 



294 HISTORY O* VELLOW FKTER. 

The AvMte garrison of Goree was immediatelT trans- 
ferred to a point near To^ only a few being retained for 
emergencies. These were qnartered in the Castle, the 

Mgliest part of the town. 

From June 23rd. to July 4:th, nothing abnormal was 
observed. Thinking that the death 6f the soldier was 
merely an imported case, and that no others would resnlt, 
the comjjany which had been sent to Yof, was recalled. 
The return of theii^ comrades was taken as a pretext for 
jollification by the soldiers in the Castel, and mnch carons- 
ing and di^tmkenness ensned. The personnel of the gar- 
rison numbered serenty-fiTe. 

On July ll:th, one of the soldiers who had retncned from 
Yof, was taken ill and died five days later. _ 

From that date, the cases followed each other in rapid 
snccession — three on the 16th, two on the 18th, one on the 
19th. two on the 20th, and one on the 21st. Thns it went 
nntil the end of July, when a total of nineteen cases and 
seventeen deaths was i^ecordecL 

Three cases were observed in August^ the last on the 
17th. 

The total number of cases at Goree were 22 ; deaths, 20. 
]S^ot a native was attacked, this frightfnl tribnte to the 
scourge being paid only by EuroxK*ans. 

EuFisQn:. 

On May 12th^ 1900, a clerk employed by the Compagnie 
Francaise de VAfrique Occidentale was taken ill at 
Eufisque, and transported to the hospital at Dakar, where 
he made an uneventful recovery. 

May 17th. two new cases. 

For over a month, no other cases. On June 21st. an- 
other employee of the Compagnie Francaise was taken Ul 
and died shortly afterward. 

This case caused some consternation, and the railroad 
terminus, which had been moved from Dakar to Eufisque, 
was changed to Thies. A part of the white x>opulation of 
Rufisque became apprehensive, and 68 took passage for 
France on the steamship) frupfis. 



SENEGAL, 1900. 295 

June 22nd, four new cases, followed by three deaths. 

Nothing abnormal until July 9th, when two new cases, 
followed by death, were observed. 

No other cases in July, probably due to the fact that 
nearly all the non-immunes had fled. 

In August, 3 cases and 2 deaths. 

In September, no cases in town, but one on board the 
Steamship Faidlierhe^ followed by death. 

October 26th, one case. 

No cases in November, but on December 24th, a clerk 
who had arrived from France on the 10th of the month, 
died with black vomit. 

The total number of cases reached 18 ; deaths 15. 

Saint Louis. 

Saint Louis had more cases than all the other localities 
in Senegal combined, and came within 21, of equaling the 
combined mortality of all the other afflicted places. The 
statistics for the colony are 416 cases and 225 deaths ; the 
figures for Saint Louis alone, 218 cases and 102 deaths. 

It will be remembered that a sporadic case of yellow 
fever was observed in Saint Louis, on May 23, 1900, in the 
person of a Moroccan, who, with a companion, had arrived 
from Dakar eight days previously. The patient died on 
May 26th. The physicians of Saint Louis denied at the 
time that it was a case of yellow fever, but when the dis- 
ease had become epidemic in the town, they Admitted that 
they had been mistaken in their diagnosis. 

The death of the Moroccan was not followed by imme- 
diate results and no new cases were observed until July 
16, seven weeks later, when the fever manifested itself 
simultaneously in opposite parts <^f the town, one case in 
the Eognat-Sud barracks, located in the center of the 
island, and the other at No. 14 Rue de la Mosque, at the 
north end. 

The case in the Rue de la Mosque proved to be the com- 
panion of the Moroccan, who had died on May 26th, in 
this same house. He died on July 17th. Dr. Kermor- 
gant attributes this fatal case to emanations from a trunk 



296 HISTORY OF YELLOW FEVER. 

containing clothes wMch had been packed at Dakar, when 
the foreigners took their departure, and which was opened 
for the first time at Saint Louis in the beginning of July. 

The infection of the Kognat-Sud barracks, acording to 
Dr. Kermorgant, was caused by the opening of hogsheads 
packed with military garments brought from Dakar by 
the steamer Saint-Kilda., and which had been distributed 
among the soldiers without being disinfected. 

But, why not directly accuse the Saint-Kilda of being 
the active agent of importation? It is of record that the 
vessel had sojourned five days at Dakar before proceeding 
to Saint Louis, and that communication between the crew 
and the inhabitants of the village had been uninterrupted. 
At Saint Louis, the Saint Kilda was subjected to a quar- 
antine of only three days, and her cargo consisting mainly 
of cases of cotton and woolen goods, was disinfected ex- 
ternally, and only unpacked when it had reached the con- 
signees. Of course, the contention that the infection was 
carried by these goods is too puerile to admit of argu- 
ment, but it is a well-known fact that mosquitoes will live 
for days without water, and even if a solitary infected 
Stegomyia had found lodgment in one of the packing- 
cases, this was sufficient to spread the contagion. And 
this is undoubtedly what happened. 

There is no doubt in our mind that the infection was 
brought by the Saint-Kilda. During the time the ship 
was quarantined, the passengers and crew were allowed 
free intercourse with the shore, and the crew are said to 
have been quite "chummy" with the soldiers, mingling 
with them in barrooms and other places generally fre- 
quented by sailors. We do not wish to convey the impres- 
sion that this affiliation could transmit the germs, as they 
are not disseminated by contact, but relate the incident to 
show that no precautions at all were taken to prevent the 
importation of the disease into the capital, although it 
was a notorious fact that Dakar was at the time a hot-bed 
of contagion. 

The simultaneous explosion of the disease in two widely 
separated sections of the town can be explained by the 
supposition that the Moroccan, like all those of his race, 



SENEGAL, 1»J00. 297 

who come by hundreds to Senegal every year, was em- 
ployed as laborer along the river front, and formed one 
of the gangs engaged in discharging the Saint-Kilda. The 
opening of a trunk almost two months after the death of 
the first Moroccan could not create a new focus of in- 
fections. No Stegomyiay no matter if endowed with phe- 
nomenal vitality, could live for that length of time shut 
out from water and air, and we must look elsewhere for 
the source of contamination. And, naturally, we incrimi- 
nate the vessel under discussion. 

It is worthy of note that all the custom]house employes 
who assisted in checking and examining the cargo of the 
Saint-Kilda^ were one by one attacked by the disease 
in the beginning of the epidemic. This, of itself, 
should suffice to incriminate the vessel. There is no record 
of the appearance of the disease on board, but as the crew 
were principally natives, whose immunity to yellow fever 
is proverbial, and the officers were probably acclimatized, 
the vessel escaped an invasion. 

But here comes our astute friend, Mr. Doubting 
Thomas, with his over-ready interrogation point, and 
wishes to know ^ow it is that the ease of the first Moroc- 
can, who died on May 26th, did not disseminate the germs 
far and wide, but that the disease only became epidemic 
in July? The explanation is just as easy as eating water- 
melon with a spoon. The case of the first Moroccan was 
a notoriously imported one. The poison was in his sys- 
tem when he left Dakar for Saint Louis, and the natural 
sequence was that it manifested itself when the period of 
incubation had reached its limit. Had he gone to Paris, 
London or any other place on the face of the earth, which 
could be reached within the period of incubation, the dis- 
ease would have asserted itself just the same. And, as 
at Saint Louis, it would have stopped right there, if the 
active agent of dissemination, the Stegomm, was not 
' present to convey the poison. And what saved Saint Louis 
from invasion in May, was the fact that the cold season 
was not yet over, and the yellow fever mosquito had not 
yet begun its activity. 



298 • HISTORY OF YELLOW FEVER. 

In July, when the Saint KUda arrived at Saint Louis, 
fresh from a nidus of infection, conditions were different. 
The mosquito season was in its zenith, and a single case 
of yellow fever was all that was needed to cause an epi- 
demic. And, as we shall see, the capital of the colony 
provided an ideal field for the propagation of the malady 
and paid the heaviest penalty. 

Although the first death from yellow fever in the 
Rognat-Sud barracks took place on July 17th, the garri- 
son was only removed from that place on July 25th, up to 
which time, eleven soldiers had already been attacked. 
About twenty were left behind, and this imprudence was 
the cause of successive contaminations, the barracks thus 
becoming one of the most active foci of infection. 

The second focus, created by the case in the Rue de la 
Mosque, radiated towards the north, successively infecting 
all that section between the starting point and the native 
quarters. 

A third focus was created in the quarters . devoted to 
colonial affairs, where the goods from the Saint-Eilda had 
been landed, and thence radiated towards the southern 
part of the city and across the small arm of the Senegal 
to the native village of Guet-X'Dar, on the Barbary 
Peninsula. 

From July 16th, to August 5th, cases cropped out here 
and there, which goes to prove that the infection was 
pretty widely distributed. Most of these cases were fatal. 

On August 5th, seven new cases. From that date, the 
epidemic wave surged over the island with such fierce in- 
tensity, that it is hardly possible to keep pace with its 
progress. Of the twenty soldiers who had remained at 
the Rognat-Sud barracks, fifteen were sent to the military 
hospital between Auguse 7th and 21st. The majority suc- 
combed. 

On August 8th, forty-five soldiers were transferred to 
the native village of X'Dartoute and twenty to Pointe- 
Nord. These remained uncontaminated until the end of 
September, when nineteen of the men at Pointe-Nord were 
attacked. The troops were then sent to M'Pal and Louga, 
whre they remained until the end of the epidemic. 



SENEGAL, 1900. 299 

The epidemic began to subside at Saint Louis, about 
September 15th. New cases were observed September 
20th, 25th, 26th and 27th, and October 5th, 10th 13th 
and 14th. 

There were no cases in November. 

On December 31st, one new case, a civilian from Louga. 

A civilian who had recently arrived in the colony was 
taken ill on January 14th, 1901. The epidemic of Saint 
Louis thus came to an end on that date, after having 
la/st;ed for nearly six months, if we are to compute the 
true epidemical period from July 16th, or nearly eight 
months, if we calculate from May 26th, the date of the 
first case. During that time, ninety-nine Europeans and 
three natives had fallen victims to the saffron scourge. 



Thies. 

On May 11th, 1900, a Moroccan who had arrived from 
Dakar, a week prevously, died at Thies. As in all other 
instances of "first cases," in other localities, a long inter- 
val elapsed before another case manifested itself. On 
August 27th, more than three months after the case im- 
ported from Dakar, an agent and a doctor arrived at Thies 
from Saint Louis. The agent was taken ill on his arrival 
and the doctor on the 29th. Both cases were sent to the 
Dakar hospital. Another case erupted on Auguse 31st. 
Altogether, seven cases were observed, the last on Feb- 
ruary 28th, 1901. 

Total cases, 7; total deaths, 4. 

TlVOUANE. 

The first case at Tivouane, took place in August, 1900. 
This case was followed by recovery. Cases were 
also observed on October 2nd, November 15th, and Novem- 
ber 25th. The last case took place January 18th, 1901. 

Total cases, 4; total deaths, 4. 



SOO HISTORY OF YELLOW FE\'ER. 



Ox Vessels. 



Recalling the fearful ravages made bv yellow fever on 
board the vessels doing service in the colony in 1878, every 
government vessel was ordered to keep away from the 
centers of infection during the erjidemic of 1900. The 
only vessels which were retained, were the EirondeUe, the 
Heroine and the Ahl'a. All three were finally infected. 

The AhJca. which did service as a water-boat, had a crew 
of eleven natives and six Europeans. It was anchored 
opposite Saint Louis during the epidemic of 1900, and 
was used for transferring the troops from one post to an- 
other, as they successively became infected. The first 
case on board occurred on August 11th, followed by three 
others. Only one death resulted. 

The Heroine, which was used as a floating hospital, had 
a crew of twenty-four Europeans. The vessel was anchored 
opposite Dakar. The first case on board occurred July 
25th, the second, August 10th. From August 10th to 
11th, five new cases. Between the 11th and 25th, there 
were only six Europeans on board the pontoon. On the 
last mentioned date, two new cases, followed by others 
on the 26th and 27th. In short, from July 25th, the date 
of the first case, to August 27th, nine cases developed on 
board, followed by six deaths. 

On August 20th, contrary to the wishes of the colonial 
government, a number of officers were sent on board the 
Hirondelle, with instructions to proceed to French Sou- 
dan. Forty-eight hours after the departure of the vessel, 
yellow fever broke out on board. The facts were imme- 
diately cabled to the government, and the H iron dell e ^^s 
ordered to return to the capital, without touching at any 
point on the river. On her return, the captain reported 
that five cases and two deaths had taken place during the 
voyage. 

STATISTICS OF THE YELLOW FEVER EPIDEMIC 
IX SEXEGAL, 1900-1901. 

The yellow fever epidemic which ravaged Senegal from 
April ieth, 1900, to February 28th, 1901, may be con- 
sidered as one of the most virulent explosions of the dis- 



SENEGAL, 1900. 



301 



ease on record. Almost the entire non-immune popula- 
tion fled when the disease was officially declared epidemic, 
and nearly all the white troops were ordered back to 
France. Notwithstanding this depopulation, one hun- 
dred and twenty-nine soldiers were attacked, and sixty 
died, and of one hundred and sixty-seven civilians at- 
tacked, one hundred and three died. The mortality would 
certainly have been terrible had not three thousand 
Europeans sought security in flight. 

Every walk of life was invaded. Soldiers, ecclesiastics, 
civilians, and strangest of all, natives paid tribute to the 
awesome pestilence. For the first time in the history of 
yellow fever invasions in Senegal, the natives were pro- 
miscuously attacked. The black troops alone furxiished 
twenty cases and eight deaths. 

The appended tables, compiled expressly for this work 
from official records, will be found interesting, especially 
Table B, as it is the first time in the annals of epidemiology 
that a complete resume of an epidemic in Western Africa 
has been obtained. 



SENEGAL EPIDEMIC OF 1900. 
Table A. Localities Afflicted, with Cases and Deaths. 



LocaUty 


Source of 
Infection 


Datp. of 
ist Case 


D«te of 
l8t Death 


Date of 
Last Case 


Date of 
Laat Death 


Toi'l 
Ca«es 


Tot"l 
D»th 


Carabane 










4 


4 


Dakar 


Disputed 


Apr. 16 


Apr. 16 


Nov. — 


Nov. - 


142 


76 


Goree 


Dakar 


June 20 


June 23 


Aug. 17 


Aug. — 


'I'i 


20 


Mehke 












1 





N'Dande- - 












1 


1 


Rufisque 


Dakar 


May 12 


June — 


Dec. — 


Dec. 24 


18 


15 


Saint-Louis.. 


Dakar 


May 23 


May 26 


Jan. 14 
1901 


Jan. '01 


218 


102 


Thip«? 


Dakar 


May — 


May 11 


Feb. 28 
1901 




7 ' 


4 






Tivouane 


Rufiisque 


Aug. — 





Jan. 18 
• 1901 




3 


3 








i 








416 


225 



302 



HISTORY OF YELLOW FEVER. 



Table B. Classified Eesume of Cases and Deaths. 



Cases. Deaths. 

Marines 65 34 

Gunners 29 12 

Spahis 7 5 

Instructors 3 1 

Total among white 

troops 104 52 

Native sharpshooters . . 25 8 

Total among troops — - — 
Municipal Service: 

Hospital Corps 23 8 

Gendarmes 4 3 

Unclassified 1 1 

Total among munici- 
pal employes — — 

Colonial Government Service: 

Local Marine Corps . . 16 10 

Department of Fi- 
nance 2 

Department of Public 

Works 2 2 

Department of Agricul- 
ture 4 1 

Department of J u s - 

tice 1 1 

Customhouse Inspec- 
tors 8 6 

Post-Office and Tele- 
graph 4 2 

Home Office 6 2 

Unclassified 9 5 

Total among govern- 
ment employes ... — -- 



Total 
Cases. Deaths. 



129 



60 



28 



12 



52 



29 



SENEGAL, 1900. 303 



23 


13 


5 


5 


2 





10 


3 


167 


103 


416 


225 



Miscellaneous : 
On board local vessels 

Ecclesiastics 

School teachers 

Sisters of Charity . . . , 
Civilians 



OrJGlN OF THE EFIDEMKI. 

When the first case of yellow fever broke out at Dakar, 
on April 16th, 1900, health conditions were excellent 
throughout the colony. There had been no outbreak in 
Senegal since 1882. Under the circumstances, the ques- 
tion naturally propounds itself: What was the cause? 
It could not have been a recrudescence of the epidemic, for 
such a thing is impossible after a lapse of eighteen years. 
It could not have been caused by the digging of the soil 
and the shifting of earth laden with dejections from pre- 
vious epidemics, for yellow fever germs do not propagate 
in this fashion. There is only one door left open : Impor- 
tation. But whence and how? The answer is as elusive 
as the honest man whom our old friend Diogenes is no 
doubt looking for through the trackless regions of the 
nether world. 

Let us see what localities were suffering from yellow 
fever in 1899 and 1900, and we may find a clue. 

In 1899, the French Ivory Coast was the only locality 
in Africa where yellow fever prevailed. The only other 
cases in the Eastern Hemisphere were imported from Vera 
Cruz, and were observed on shipboard in the harbor of 
Nantes on the western coast of France. The fever pre- 
vailed epidemically in Central America, Mexico, the 
United States, the West Indies and South America. 

Could infected mosquitoes have been imported from 
Grand Bassam to Dakar, in 1899, where they hibernated 
until the advent of warmer weather? The Ivory Coast is 
a French possession and communication between the capi- 
tal of that dependency and Senegal was almost uninter- 



3U4 HISTORY OF YELLOW FEVER. 

rupted, in spite of quarantine regulations. Smugglers in- 
fest the coast and they are certainly not respectors of san- 
itary or any other laws. 

In 1900, yellow fever had not been obseryed in Africa 
previous to the outbreak at Dakar. We must, therefore, 
look elsewhere for the source of importation. Epidemics 
of more or less intensity prevailed that year in Central 
America, Mexico, the United States, Brazil and Columbia. 

The early appearance of the disease at Dakar, precludes 
any possibility of its having been brought from the United 
States, for the disease only manifested itself in this 
country in the middle of the year. It rarely begins before 
July. 

In South America, however, conditions are different. 
There we find yellow fever in almost any season of the 
year. The disease was very severe in Brazil, in 1899 and 
1900 — the death-rate being 731 for the former and 344 for 
the latter year. South America has been a notorious focus 
of infection since the early fifties, when the scourge estab- 
lished itself epidemically in Brazil, and it is quite natural 
to suspect Rio de Janeiro or its sister cities of having con- 
taminated Senegal in 1900. Yellow fever is present in 
Rio de Janeiro, from January to December, each year. 
Trade relations between Brazil and the West Coast of 
Africa is quite brisk. In addition to the independent 
craft which ply between the two continents, two French 
steamship companies make regular trips from France to 
Brazil, and the La Plata region, stopping at Dakar on 
their return trip. A case of yellow fever, or infected mos- 
quitoes could thus easily be transported from the epidemic 
foci of South America to the shores of Senegal. 

It is of record that two of these French vessels brought 
yellow fever cases from Senegal to Havre (q. v.) during 
the epidemic of 1900, the GaravaMes, August 9th, and the 
Santa Fe, August 10th. These cases were infected at 
Dakar, where the steamships had touched, to take passen- 
gers for France. The fever did not spread, for the simple 
reason that the yellow fever mosquito does not flourish at 
Havre, and whatever infected insects had been taken on 
board the vessels while in Senegal, perished when they 



SENEGAL 1905. 805 

reached an altitude hostile to their existence. Under the 
same conditions, the fever could be transported from 
South America to Senegal, but with different results, for 
the Stegomyia Calopiis flourishes in nearly every country 
on the West Coast of Africa, and a single infected female 
of that species is all that is needed to start a focus, 
which can eventually contaminate the entire coast. 

Dr. Kermorant denies the charge of importation, either 
from other African stations or South America, leaning to 
the theory of revivescence of germs from previous epi- 
demics by the disturbance of the soil, a dogma which at 
the present day has reached the last stages of attenuation. 

There is, we repeat, but one possible source : Importa- 
tion. But whence or how, we can only surmise, having no 
proofs. 

1901. 

Sporadic cases of yellow fever were observed in Senegal, 
during 1901. The first case of the year manifested itself 
at Thies, on January 3rd. A fatal case was observed at 
Saint Louis, on January 14th, and one at Trivouane, on 
the 18th of the same month. Another case erupted at 
Thies, on February 28th. With the exception of a case 
at Dakar, on A|pril 10th, no others were observed until late 
in the year. Between September 21st and October 13th, 
two cases erupted at Dagana and three at Saint Louis, 
followed by three deaths. ^^ 

Total cases for 1901, 10 ; total deaths, 5. 

Nearly all these cases were new arrivals in the colony. 
The disease did not become epidemic, for the simple reason 
that those who had fled in 1900, wisely remained in France. 

1905. 
For four years we hear nothing about yellow fever in 

•^Proust and Faivre: Rec. dcs Trav. du Com. Consult. d'Hyg. 
Pub. de France, 1901 (Paris, 1903), p. 336; also Ker- 
miorgant: Ann. d'Hyg. et de Med. Colon., 1903, vol. 6, p. 
626. 



306 HISTORY OF YELLOW FEVER. 

Senegal, not even a sporadic case being mentioned in the 
official reports of the health of the colony. 

On May 31, 1905, the startling news was disseminated 
throughout the colony that an engineer employed at the 
water works at Dakar had died of a malady officially 
declared by the physicians, both civil and military, to be 
yellow fever. As may well be imagined, the announce- 
ment caused consternation among the European popula- 
tion, and a general exodus took place. All steamers sail- 
ing for Europe were crowded to their utmost capacity, 
as a repetition of the disaster of 1900 was apprehended 
and the large number of non-immunes then in the colony 
concluded that they would be safer with the ocean between 
them and the seat of contagion. 

According to Mr. Strickland, ^^ American Consul, and Dr. 
Eibot,^^ the authorities at Goree-Dakar, warned by the 
disastrous epidemic of 1900, used the most energetic meas- 
ures to prevent the disease from spreading. The house 
where the patient died was burned and his effects 
destroyed, the government assuming the loss. His family 
was isolated and all suspicious cases of sickness were 
closely watched. The chief health officer of Goree pur- 
chased two immense woven-wire cages which had been 
used by Consul Strickland during his sojourn in Senegal, 
one to sleep in and the other to enclose his writing-table 
and book- cases. The largest case was capable of accom- 
modating two single beds, a chair and a table, while the 
smallest could contain a bed, a chair and a table. The 
cages were mounted in the hospital, and all cases of sus- 
picious fever were placed therein. Our representative 
says that he has used such cages since 1877, and attributes 
his immunity from the diseases incidental to the climate 
to this precautionary measure. 

Orders were received by the colonial government from 
the mother country to wage incessant warfare against the 
mosquitoes in general and the Stegomyia Calopus in par- 
ticular, as the female of this species, and not dirt, eman- 
«"« Strickland: U. S. Public Health Reports,' 1905, vol. 20, p. 

1473. 
«*Ribot: Annales d'Hyglene etde Medicine Coloniales (Paris), 

1907. vol. 10. p. 79. 



SIERRA LEONE 307 

ations or buried germs were responsible for the spread of 
yellow fever. 

An old and tried proverb asserts that an ounce of pre- 
vention is better than a pound of cure, and to the strict 
sanitary measures adopted by the authorities, Senegal 
probably owes her escape from an epidemic in 1905. Be 
that as it may, no other cases developed and the timorous, 
who had been on the anxious seat and only awaited the 
eruption of a second case to flee, settled down to their 
usual avocations, and the business of the colony resumed 
its normal stage. 

It would have been interesting to analyze the genesis 
of this isolated case ; but, unfortunately, beyond the report 
of Consul Strickland, we have failed to discover any arti- 
cle, which could throw additional light on the subject. 
Tlhat the case did not originate de novo is certain, f^or it 
would have been followed by others. In the absence of 
proof that it was imported, however, we cannot positively 
assert that it was of foreign origin, although we are in- 
clined to that belief. We shall leave the question for 
future theorists to elucidate. 

CONCLUSIONS. 
1908. 

Up to the time this transcript is handed to the 
printer, October, 1908, we have not heard of any other 
eruption of yellow fever in Senegal, and with the present 
known mode of transmission of the disease, there is no 
reason why yellow fever, should it manifest itself in that 
far-off land, should not be confined to a few cases. 

SIEEEA LEONE. 

Description.. 

Sierra Leone is a British erown colony on the west coast 
of Africa. It is a coaling station for the Koyal Navy, and 
the headquarters of the West Indian regiments, stationed 
on the African coast. The colony consists of Sierra 



308 HISTORY OF YELLOW FEVER. 

Leone proper, Sherbro Island, several small islands and 
the whole coast region from the lower limits of French 
Gniana, on the northwest to Liberia on the southwest. 
Capital, Freetown, where most of the inhabitants live. 

HISTORICAL RESUME. 

Sierra Leone was discovered by the Portugese, in 1463, 
but no settlement was attempted, owing to the deadly 
nature of the climate and the ferocity of the savages who 
inhabited the interior. From time to time, spasmodic 
efforts were made to establish colonies along the coast, but 
the mortality which attended these efforts was such, that 
Sierra Leone was designated by Europeans as "The White 
Man's Grave," an appellation which has clung to it to 
this day. 

On May 9th, 1787, about sixty Englishmen and four 
hundred blacks landed at the peninsula of Sierra Leone, 
and founded Freetown, which was destined to be the haven 
of all the escapeS, rescued and emancipated slaves of the 
world. On September 16th, 1787, disease had so deci- 
mated the colony, that only two hundred and seventy-five 
persons remained. These either emigrated to other climes 
or were murdered by the natives. In 1791, the English 
Parliament, to encourage the work of the abolitionists, 
authorized the formation of a powerful company. The 
year following, this company sent 1200 liberated slaves 
from Nova Scotia and the Bahamas to rebuild the aban- 
doned town of Freetown. Shortly after, a pestilential dis- 
ease ravaged the colony and the project was about to be 
abandoned, when an Englishman named Clarkson, a 
brother of the originator of the scheme, took energetic con- 
trol, and induced the pioneers to remain. The ill-starred 
venture was destined to again suffer destruction. In 
1794, a French squadron, not knowing of the philanthropic 
nature of the settlement, but seeing only a possession of 
the hated Englishman, completely destroyed the town. 
The French government severely censured the command- 
ant of the squadron for this action, but it was too lat6 — 
Freetown was a heap of debris. 



SIERRA LEONE. S09 

With the stubbornness which characterizes the Brit- 
isher, and to which is due his eminence in the history of 
nations, John Bull resolved to again put its pet scheme 
into execution, and in 1808, purchased all the rights of 
the Sierra Leone Company, and the territory became an 
English possession. In 1812, a new mode of colonizing 
the country was put into execution. All slaves taken 
l^rom ships captured by the English, were sent to Sierra 
Leone, and given their liberty. From that date, the colony 
prospered and became the Mecca of emancipated slaves. 

Other towns were founded in rapid succession : Leices- 
ter, in 1809; Regent, in 1812; Gloucester, in 1816; Leo- 
pold and Kissey, in 1817; Charlotte, Wilbeforce and Bat- 
hurst, in 1818; Kent, York, Wellington, Hastings and 
Waterloo, in 1819. 

The population of Sierra-Leone grew rapidly. In 1811, 
there were 4,500 persons, half of which were liberated 
slaves; in 1819, it had more than doubled, being 12,000, 
including 200 white soldiers; in 1828, it had grown to 
17,566, and in 1849, to 46,569. The last census (1891), 
gave the dependency a population of 74,835, mostly natives 
and descendants of liberated slaves. 

From 1812 to 1835, the liberated slaves sent to swell the 
population of Sierra Leone, amounted to 27,167. 

The European population was more numerous in the 
first years of the colony than afterwards. This was due 
to the fact that the insalubriety of the climate is extremely 
hostile to the whites. In 1818, the town of Regent, alone, 
had a population of 1300 whites and 1700 blacks. In 
1826, only 535 English soldiers could be found in the) 
entire colony. To-day, the population is almost totally 
black. A few white merchants remain during the healthy 
season, but as soon as the rains set in, they return to 
Europe. The white soldiers have been replaced by blacks, 
and with the exception of a few white officers, the gov- 
ernor and his clerical help, no whites reside permanently 
in the colony. 

{ THE FEVERS OF SIERRA LEONE. 

Sierra Leone may now be considered as one of the en- 



310 HISTORY OF YELLOW FEVER. 

demic foci of yellow fever in western Africa. Previous to 
1763, when the disease was imported to the colony, it was 
unknown; but, finding a home suitable for its retention 
and propagation, it took firm root, and is now one of the 
natural products of that insalubrious region. 

According to Lamprey,^^ there are three types of fevers 
commonly met with in Sierra Leone: (1), ague; (2), bili- 
ous fever, and (3), pernicious or yellow fever. The first 
is not of frequent occurrence; the second is the common- 
est; the third the most fatal. Dr. Lamprey, who made a 
special study of the yellow fever outbreaks in Sierra 
Leone, observed that, though, the character of these fevers, 
when developed, show a distinctivenss of type one from 
another, yet so alike are they at the incipiency of the 
attack, that it requires some experience to define them. 
Tt is found expedient to carefully watch the various symp- 
toms of a suspicious case, before absolutely pronouncing 
the disease to be yellow fever. 

The unsanitary condition of Freetown is especially 
adapted to the propagation of pestilence. The city is 
situated in an amphitheatre, surrounded on three sides by 
a range of hills rising from 500 to 3,000 feet above the 
town. In this circumscribed area, a large and dense pop- 
ulation are crowded together. The houses are, for the 
most part, unscientifically constructed and illy ventilated, 
and are surrounded by privies, cesspits and wells. From 
the latter the inhabitants obtain their drinking water. 
During the "wet" season — May to August — it rains in- 
cessantly. The natural slope of the land drains this heavy 
rainfall into the cesspits and vaults, which overflow into 
the wells, concocting a beverage for the benighted Free- 
townites, compared to which Carizzo water would taste 
like nectarine frappe. 

From the above conditions, it will readily be understood 
why the fever is so often epidemic in Sierra Leone, and is 
productive of such a high rate of mortality. 

•* Lamprey: British Medical Journal, 1885; vol. 2, p. 594. 



SIERRA LEONE — 1763-1778. 811 

.1 

A review of the literature on the subject brings forth 
no evidence of the fever ever having been imported into 
Sierra Leone, but rather leads tO' the conclusion that an 
endemic fever prevails every year in that country, being 
most prevalent in the lowest and most crowded sections of 
Fretown. It arises purely from local causes. At certain 
epochs this fever acquires great development and becomes 
epidemic, and, although its symptoms remain the same, 
they are much heightened in intensity ; remissions are less 
common, black vomit is more frequent and the mortality 
greater. 

YELLOW FEVER YEARS. 

1763; 1764; 1766; 1778; 1807; 1809; 1812; 1815; 1816; 
1819; 1822; 1823; 1825; 1826; 1828; 1829; 1830; 1836; 
1837; 1838; 1839; 1845; 1847; 1848; 1858; 1859; 1862; 
1864; 1865; 1866; 1868; 1872; 1878; 1884. 

SUMMARY OF EPIDEMICS. 

1763 TO 1766. 

According to Lind,^^ yellow fever prevailed in Sierra 
Leone, in 1763, 1764 and 1766. The reports lack authen- 
ticity. 

1778. 

The first authentic appearance of yellow fever in Sierra 
Leone, took place in 1778, according to Schott.^'^ No de- 
tails are given, probably because the whites were so scarce 
in the country that only a few cases resulted among them ; 
but it is an historical fact that the fever was carried from 
Sierra Leone to Gambia, and from Gambia to Senegal, 
where it decimated the English garrison stationed at Saint 
Louis. 

®®Lind: Diseases Incidental to Europeans in Hot Climates. 
•'^ Schotte : A Treatise on the Synochus Atrabiliosa, London, 
1782. 



SI? HISTORY OF YELLOW FEVER. 

1807 TO 1816. 

Yellow fever was present in Sierra Leone, in 1807, 1809, 
1812, 1815, 1816, 1819 and 1822, but only sporadically.^^ 
The mortality among the Europeans was high. 

1823. 

The first epidemic of which any details are given, 
is that of 1823, described by Bryson.^^ The focus 
of this epidemic began on December 11, 1822, when an 
isolated case of ''suspicious fever" was observed, followed 
by death. The patient was the harbor-master of Sierra 
Leone, and had been on board no infected vessel, nor had 
been exposed, as far as Dr. Bryson could ascertain, to any 
other infection except that of the common endemic and 
local fever. Six weeks afterAvards, another case occurred. 
The third positive case occurred on the 22nd of February, 
1823, in the person of a seaman from the ship, Caroline^ 
who had been loading timber up the river. Some weeks 
previous to the diagnosis of this case, the Caroline had 
lost several of her crew from fever contracted while the 
vessel was being loaded at Freetown. Cases subsequently 
occurred among the crew of other vessels and among tue 
inhabitants of Sierra Leone, and the fever gradually be- 
came widespread. 

The epidemic appears to have gradually declined, and 
finally ceased at Sierra Leone, and, as far as can be ascer- 
tained, in the shipping in the adjacent rivers, in June or 
July. As there had been a first case of a doubtful char- 
acter preceding by several weeks or a month, the general 
outbreak, so it might be argued, there was a last case of 
a similar nature, which followed its general extinction at 
an equal distance of time. The last case which occurred 
in June, proved fatal on the 12th of the month, when the 
heavy rains set in. But there was another, an ''isolated 

** Berenger-Feraud and L/cmprey, loc. cit. 

"'Bryson: An Account of the Origin, Spread and Decldne of 

the Epidemic Fevers of Sierra Leone (London, 1849), 

p. 14. 



SIERRA LEONE 1823. 3l3 

case," that of Mr. Huddleston, a Wesleyan preacher, which 
occurred about the middle of July; he was then convales- 
cent from an attack of the common remittent, a disease 
he was subject to during the rains. On returning from 
his religious duties, he felt indisposed, and became fever- 
ish, but it was considered to be merely a relapse of the 
remittent. On the third day, however, it manifested symp- 
toms of the fatal epidemic. On the evening of the fourth, 
black vomit made its appearance; and the next evening, 
the 20th of July, the afflicting scene closed. This gentle- 
man resided in the same house with his brother-in-law, 
who died of the epidemic fever on the 16th of April ; he 
was besides, during that and the following month, when 
the disease was at its greatest degree of severity, fre- 
quently at the bedside of those who were suffering from 
it, without being affected himself. '^^ 

As the epidemic disappeared, the ground was found 
occupied by the endemic, exhibiting about the same degree 
of intensity it had when the former threw it into the 
shade, in the early part of the year ; subsequently, it pre- 
vailed for several years amongst all classes of Europeans, 
from the Gambia down to the easternmost point of the 
Gold Coast, with unprecedented severity. The deaths on 
some of the cruisers were numerous, but amongst the 
troops stationed at Bathurst, Cape Coast and Accra, they 
were truly appalling. To say that upwards of three- 
fourths of the whole were annually, for several years, cut 
off by fever, would be far within the mark.'^^ 

The fever was imported from Freetown, in March, 1823, 
to the Island of Ascension (q. v.) by the sloop of war 
Bann, an incident which gave rise to discussions which re- 
main unsettled to the present day.'^^ 

1825. 

Yellow fever prevailed in Sierra Leone, in 1825, result- 
ing in a mortality of fifty per cent.^^ 

^"Bryson, p. 31. 
"Bryson, p. 32. 
"See "Ascension Island," in this volume, for details of this 

famous case. 
" Second Report on Quarantine, 1852, p. 288. 



314 HISTORY OF YELLOW FEVER. 

1826. 

No details are obtainable concerning the outbreak of 
1826, as the English medical archives are as silent as the 
grave on the subject, but according to Dupont and Beren- 
ger-Feraud/^ the ship, Sijhille was infected at Freetown, 
during the summer of 1826, and lost a great many of her 
crew on the voyage from that port to Saint Helena. The 
English nosologists denied that the disease on the Syhille 
was yellow fever, claiming that the contagion would have 
spread to the Island of Saint Helena had such been the 
case, but it must be borne in mind that the outbreak took 
place about the end of August, the coldest month in the 
Southern Hemisphere, and that Stegomyiae do not circu- 
late when the temperature is below the freezing point. 

1828. 

Yellow fever reappeared during the summer of 1828. 
The ship La Bordelaise was infected at Freetown, and 
carried the disease to Senegal (q. v.)'^^ 

1829. 

The year 1829 witnessed another severe outbreak in 
Sierra Leone. From 1823 to 1829, yellow fever was 
present almost every year in Sierra Leone. The disease 
was very fatal, but was not widespread during that period. 
In April, 1829, however, the fever assumed a most malig- 
nant type. As in 1823, the first cases were scattered and 
were not imported; they seemed to grow out as it were 
from the endemic fever, from which, indeed, some of the 
cases appear to have been scarcely distinguishable. Then, 
gradually increasing, the disease spread as an epidemic 
among the European seamen and the white population 
residing along the lower left bank of the river, the very 
locality in which the fever of 1823, had committed such 
terrible ravajjes."^^ 



"Dupont, loc. cit.; Berenger-Feraud, p. 104. 

" Berenger-Feraud, p. 105. 

'° British and Foreign Medico-Chirurgic2.1 Review, 1849; Vol. 
4, p. 465. 



SIERRA LEONE 1829. SI 5 

According to Boyle, "^^ the first well marked fatal case 
was that of Mr. Loughman, a writer in the Colonial Office, 
a young man of ^'a sensitive mind, but somewhat careless 
as to his modes of living." He was seized on the 21st of 
April, and died on the 28th, under all the symptoms of 
the epidemic, then known. There was no means of trac- 
ing this case to imported contagion, or indeed any reasons 
to presume it was so contracted. 

The next case appears to have been that of a midship- 
man of the Eden, who was taken ill in the harbor, on the 
29th of April, on board a detained vessel of which he had 
charge, and died on the 5th of May, on the Eden, to which 
he had been removed. In this vessel there was another 
subordinate officer, who was attacked the day after the 
above, as he himself supposed, in consequence of his hav- 
ing ^'got wet in a tornado." His symptoms were decidedly 
those of yellow fever. On the 3rd of May, his dejections 
became black; on the 4th, his eyes and skin were yellow, 
with a dirty brown tinge on the fifth, his urine was turbid 
and offensive ; on the 6th,, he began to sink, and died early 
on the morning of the 7th, on the detained vessel. Blood 
was taken from the arm early in the disease, but the 
wound never closed, and it bled to the last, when the 
bandages were removed or torn off by the patient when 
delirious; it resembled the orifice made in the vein of a 
dead subject. 

The next case on record, although there is little reason 
to doubt that there were others occurring at the same 
time, is that of a man, who, after wandering for several 
days about Freetown in a state of destitution, was received 
on board the Eden, on the 1st of May, as one of her crew. 
On the evening of the 3rd, he was attacked with fever; 
on the 6th his dejections w^ere of a dark color, and in the 
evening he vomited a dark colored fiuid, in which there 
were clots and streaks of coagulated blood. On the 7th, 
hs eyes and skin having become yellow, he began to sink, 
and died at four in the afternoon. 

"Boyle: A Practical Medico-Hisitorical Account of tbe 
Western Coast of Africa, (London, 1831), p. 255. 



316 HISTORY OF YELLOW FEVER. 

The next case was that of a traveler who came down to 
Sierra Leone in an open boat, and being intoxicated, slept 
part of the time, although exposed to the fury of the north- 
east tornado, accompanied with heavy rain. He was 
seized on the 4th of May, the day after his arrival at Free- 
town, and died on the 10th. 

On the 9th of May, one of the merchants of Freetown 
was attacked, and died on the 16th. In this instance 
death was preceded by yellowness of the skin and black 
vomit. 

The cases then became more frequent and almost every 
European who had not fled from Freetown, suffered an 
attack. The malady lasted without interruption until 
1830, when it gradually subsided and was succeeded by the 
endemic bilious fever. 

The Eden,, which, as we have seen, had been infected at 
Freetown, in 1823, an event which caused endless contro- 
versies between the medical men of the period, was con- 
taminated at Freetown, in 1829, and lost 110 men out of 
a crew of 160, besides leaving her sick at numerous ports 
on the African coast, which were thus infected and suf- 
fered much from the ravages of the disease. 

The Champioji was also infected at Freetown, in 1829, 
and carried the fever to Fermando-Po (q. v.), where it 
caused much mortality. 

1830. 

Many cases were observed in 1830, but the disease did 
not become epidemic, gradually subsiding during the sum- 
mer and finally blending with the bilious fever annually 
present in Sierra Leone. 

1836. 

For six years, nothing is said about yellow fever in 
Sierra Leone in the official medical reports, although there 
is no doubt in our mind that the disease, if it did not pre- 
^ail annually, must certainly have been present at some 
time or other during these dates. 



SIERRA LEONK. 1837. 31? 

In December, 1836, the fever broke out suddenly at Free- 
town, and lasted until January, 1837. The cases and 
deaths are not given.^^ 

1837. 

The focus of the epidemic of 1837, began in December, 
1836, as mentioned above. 

The genesis of this epidemic as set forth by Bryso^n 
(page 67) is interesting and shows how fatal to 
Europeans, especially new arrivals, is the African type of 
yellow fever. 

It appears by a report from Staff-Surgeon Ferguson, 
then Governor of Sierra Leone, that a vessel called the 
Mary J arrived from England on the 9th of December, 1836, 
and immediately afterwards proceeded up the Bunce 
River for a cargo of timber, anchoring six miles above 
Freetown, close to the marshy mangrove-covered banks of 
the river. Towards the close of the month, the endemical 
remittent began to attack the crew in the order exhibited 
by the following table: 

Cases. Deaths. 

Dec. 27, 1836 1 

Dec. 29, 1836 5 

Dec. 30, 1836 5 4 

Jan. 4, 1837 2 

Jan. 6, 1837, 1 

Jan. 7, 1837 1 1 

15 5 

The master of the vessel was attacked on the 30th of 
December, and died on the 20th of January. Four of the 
crew were also attacked on the same day as the master, 
of whom three died. These, with the cases of the 27th 
and the 29th, were considered to be instances of the en- 
demial remittent. On the 6th of January, there was but 
one European left on board (the carpenter) ; he also was 
in ill health, but refused to leave the ship. He, however, 
became worse, was brought to town on the 10th of Jan- 
uary, and died on the 12th. Thus the whole of the crew 



"Bryson, p. 94. 



SI 8 HISTORY OF YELLOW FEVER. 

were attacked with the fever within the space of fifteen 
days, and a third of the number died. In these cases, 
neither black vomit nor any of the symptoms character- 
istic of the malignant remittent occurred. 

During the period embraced by the foregoing detail, the 
Europeans of Freetown wesre healthy. On the 4th of 
January, a young gentleman, who had not been a month 
in the colony, was attacked with fever of great severity, 
which, after it had been protracted beyond the ordinary 
duration of remittents, proved fatal on the 16th of the 
month. On the following day, a mulattress, who had 
been in the colony eighteen years, died of fever of ten 
days' duration. These two cases, the colony having been 
previously healthy, excited great consternation, but no 
other cases developing they were soon forgotten. 

One of the two sailors of the Mary, who had been 
attacked -^Nith fever in the early part of January, nad a 
relapse on the 9th of February, of which he died on the 
18th, having had black vomit on the day of his death. 
He had not returned to the ship, but remained at sick 
lodgings at Freetown, taking a walk morning and even- 
ing, when the fatal relapse occurred. 

The next cases were amongst the crew of a vessel called 
the Lady Douglass, which had arrived at Freetown on 
the 12th of January, and afterwards went to Melacoorie, 
a river about forty miles to the northward of Sierra Leone, 
for timber. Four men from this vessel were unfortun- 
ately sent to the same sick lodgings that had been previ- 
ously occupied by part of the sick crew of the Mary. The 
men were all taken sick, and only one of the four recov- 
ered; the others died after having presented the symp- 
toms peculiar to yellow fever. 

The malignant fever at length broke out in its worst 
form among the European residents of Freetown. The 
first case occurred on the 31st of March. Mr. White, a 
West Indian, who had resided several years in the colony, 
Captain Patrick and Mr. Crummens were on that day 
attajcked, and the two last mentioned died on the fourtli 
day of the fever. 

The third fatal case occurred on the 16th of April, the 



SIERRA LEONK 1 8S7. 319 

fourth on the 20th and the fifth on the 24th. All these 
cases terminated with the peculiar symptoms of malig- 
nant fever. The duration of the fever in the seven first 
cases that terminated in death was as follows, viz. : The 
first and second on the fourth day ; the third on the 
fourth; the fourth on the fourth; the fifth on the third; 
sixth on the sixth, and the seventh on the ninth. 

All these were males ; the next case was a Mrs. N., who 
was the first female who had the disease, and after it had 
assumed the epidemic character, she recovered. The fever 
tJius, after, as it were, maturing during a period of about 
two months, established a footing in Freetown, continued 
with great violence in May and June, and declined in 
tTuly, the attacks gradually becoming fewer and less severe 
as the rainy season approached. Nearly all the patients 
who were attacked in the latter month recovered, and by 
tlie end of July, the fever in its epidemic form, was wholly 
extinct, although sporadic cases manifested themselves 
until the middle of December. 

On Vessels. 

In May 1837, according to Bryson (page 94), yellow 
fever was contracted by the crew of the Curlew, either 
there or in one of the rivers between Sierra Leone and the 
Gambia, but wherever contracted, it was communicated by 
the ship's company to the inhabitants of Gambia, and sub- 
sequently by the latter to the inhabitants of Goree. 

In October and in November, the fever was contracted 
either at Freetown or off Cape Palmas, by the crew of the 
Raven; but, although a large proportion of the sick of 
this vessel were landed at Cape Coast Castle, they did 
not communicate the disease to the inhabitants of that 
district. 

In Decemljer, the malady under discussion was con- 
tracted at Sierra Leone by two stewards belonging to the 
English coasting vessel .E/^na; and there is reason to believe 
it was communicated by them in a most virulent form to 



320 HISTORY OF YELLOW FEVER. 

the ship's company, who carried it to the Island of Ascen- 
sion, wliere, in a short time, nearly the whole of the crew 
having suffered, it became extinct in the quarantine tents 
at Comfort Cove. 

In the latter end of December, it broke out amongst the 
ship's company of the Forester, at or shortly after leaving 
Sierra Leone, but appears to have entirely ceased on the 
passage to Ascension. At sea, however, prior to its cessa- 
tion, she communicated with the Bonitta, and discharged 
a prize crew into her, which had been embarked at Sierra 
Leone. By these men, or by some other means, the fever 
was communicated to the ship's company, and by them, 
the malady having suddenly assumed the greatest degree 
of virulence, it was again carried to Ascension (q. v.) 

1838. 

In 1838, according to Lamprey,"^^ yellow fever appeared 
in February, and ended in March. The Island of Ascen- 
sion ( q. V. ) was again contaminated by vessels from Sierra 
Leone in the beginning of the year. 

1839. 

In 1839, a severe form of "remittent fever" caused the 
death of six officers of the garrison at Tower Hill bar- 
racks. During the months of July, August and Septem- 
ber, every man of the Royal Aifrican Corps in the barracks 
at King Toms, Freetown, suffered from the fever, and the 
mortality amongst that corps is stated to have been appal- 
ling. There were seven officers and thirteen men of the 
Royal Navy attacked with yellow fever, and every one 
died.8o 

1845. 

From 1839 to 1845, there is no mention of yellow fever 
in Sierra Leone, probably due to the fact that no new- 
comers arrived during that period. 

'"Lamprey: British Medical Journal, 1885; Vol. 2, p. 594. 
"* Lamprey, loc. cit. 



SIERRA LEONE — 1847-1858. S21 

In 1845, yellow fever appeared amongst the crew of the 
squadron at anchor, off Sierra Leone. The Eclair sailed 
from the river on July 23rd, 1845, and sixty of her crew 
perished from yellow fever. One fatal case occurred in 
September. ^^ 

The Eclair contaminated Boa Vista, one of the Cape 
Verds (q. v.) 

1847. 

In 1847, yellow fever was epidemic in Freetown, in 
June, July and August. The ship Growler was contami- 
nated at Freetown, and is accused of having brought the 
fever to the Island of Barbadoes, in the West Indies. ^^ 
But as the fever was already prevailing in the Antilles, 
this importation merely added fuel to the pestilence. 

1848. 

Another outbreak of the disease took place in 1848, but 
was not severe. ^^ 

1858. 

Sierra Leone presumably enjoyed a long immunity from 
yellow fever, for no cases are recorded during the decade 
from 1848 to 1858. Whether the fever was present or not, 
we have no means of ascertaining, as the medical records 
are silent on the subject, and even our old stand-by, Ber- 
enger-Feraud, was unable to unearth any records which 
could throw light on the question. This extraordi- 
nary immunity may be explained on the theory that the 
whites, tiring of being mowed down like sheep, kept aloof 
from the colony and the blacks, who are seldom, if ever 
attacked by yellow fever, furnished no cases. 

The reappearance of the fever in 1858 is barely noticed 
by Berenger-Feraud {loc, cit., page 135), and is mentioned 
nowhere else. Only two caiuses are open to conjecture: 

" Lamprey and Berenger-Feraud. 
" Lamprey and Berenger-Feraud. 
"Berenger-Feraud, p. 118. 



322! HISTORY OF YELLOW FEVER. 

(1) That the disease had been present during all the time 
from 1848, to the '^officiar' outbreak of 1858; or, (2) That 
it was re-introduced by the shipping. We have nothing 
on which to base any argument which could sustain any 
of these propositions, but it is self-evident that one of the 
two must stand. Yellow fever cannot originate from the 
ground, and mosquitoes could not, under the most extra- 
vagant stretch of the imagination, carry the virus for ten 
years. The introduction of a single case, however, would 
be sufficient to disseminate the poison and give rise to an 
outbreak among the non-immunes unprotected from the 
bites of the insects. 

That the fever could easily have been imported to Sierra 
Leone, in 1858, (admitting, arguendo, that importation 
was necessary), will be evident by consulting our chrono- 
logical tables for that year. The fever was widely distrib- 
uted in America., and was especially severe in the West 
Indies and the eastern coast of South America. The 
English possessions in the Antilles suffered to a great 
extent. Ships carried an extensive commerce between 
Brazil, the West Indies and Sierra Leone and the im- 
portation of a single case to Sierra Leone was sufficient 
to engender an outbreak of the disease under discussion. 
That this importation took place, we cannot prove, but 
the natural inference is that it did. Experience has taught 
us that official reports are not always trustworthy, especi- 
ally when commercialism is at stake. 

1859. 

i 
The importation of 1858, must have reinfected the 
Stegamyiae of Freetown tO' quite an extent, for the fever 
broke out in April, 1859, and became epidemic in May.^* 
There had been an influx of Europeans during the past 
year, and 106 fell victims to the disease between April, 
1859, and January, 1860. 

The British war vessels Trident and Sharp shooter were 
infeeted at Sierra Leone in 1859, and carried the disease 
to the Island of Ascension (q. v.) 

** Lamprey, loc. cit. 



SIERRA LEONK — 1859- {862, 325 

Two seamen died of yellow fever on the Surprise^ off 
Freetown. One of these mien, however, belonged to the 
Spiteful, and had arrived at Sierra Leione on a prize 
vessel. Being at the time unwell, he was sent to the mili- 
tary hospital for treatment, where he recovered and was 
discharged to the Spiteful. A few days afterwards he 
was attacked with yellow fever, and died after four days' 
illness. The other patient had deserted from a merchant 
vessel, and subsequently, after leading an irregular life at 
Sierra Leone, joined the Surprise as a volunteer. Ten 
days after he came on board, he was attacked and died on 
the sixth day. 

1860. 

No mention is made of yellow fever at Sierra Leone, in 
1860, but the disease was no doubt at Freetown, as the 
British warship Arrogant was infected in that locality 
?ind lost two men. 

1862. 

The outbreak of 1862 was not severe and was not at- 
tended by much mortality. 

In the Statistical Report of the Health of the 'Navy for 
1862 (published in 1865), pp. 155-162, it is stated that the 
squadron on the West Coast of Africa suffered from yel- 
low fever. Although Sierra Leone is not directly incrimi- 
nated, the infection was no doubt contracted there. Eleven 
cases occurred on board of the Bloodhound , seven of which 
died. "At the time of the disease on board, however, 
many cases of fever of a severe nature were under treat- 
ment," writes the medical officer, "but none were classed 
as yellow fever, except those in whom the symptoms were 
unmistakable." The disease made its appearance when 
the ship was lying at Batanga. The first case occurred 
on September 15th, and died on the 18th. Between the 
15th of September and the 16th of October, there were 
nineteen cases of severe fever ( which were not reported as 
yellow fever for rasons above stated), which, assuming 
them to have been of the yellow fever type, would give 
altogether thirty cases under treatment. 



8t4 HISTORY OF YELLOW FEVBR. 

1864. 

Yellow fever did not "oflacially" prevail in 1863, and 
we find no record of any cases. In 1861, an outbreak took 
place, the facts of which would no doubt have been sup- 
pressed, but a merchant vessel brought a case from Free- 
town to Falmouth, England (q. v.), and the facts could 
not be hidden from the English public. The case, which 
proved fatal, caused much agitation in England, and the 
w^hole African coast was quarantined until the advent of 
cold weather. 

1865. 

In the Statistical Report of the Health of the Navy for 
1865, (published in 1868), pp. 196-208, it is stated that 
^'during Michaelmas" of that year, a very malignant type 
of yellow fever was prevailing on shore at Sierra Leone, 
causing a mortality of seventy-five per cent, amongst the 
European population. 

The same authority records sixty-five cases of yellow 
fever occurring on the ships Archer^ Span^oiv, Rattlesnake 
and Iris, with thirty-four deaths. The first fatal case 
occurred September 28. The last case occurred on Decem- 
ber 23(rd, and died December 26. 

All these vessels were infected at Sierra Leone. It 
seems, however, that there occurred quite a number of 
additional cases of yellow fever which were not classified 
thus, for Surgeon Samuel Clift, of the Rattlesnake^ says : 
*'I have classed fifteen cases of fever as remittent, two as 
ephemeral, and five as yellow fever, but they may all be 
looked upon as the latter disease, differing only in inten- 
sity, and as to the presence or not of black vomit." It 
seems, too, as though the general opinion prevailed that 
many more cases of fever which occurred on board the 
ships mentioned were also yellow fever. 

1866. 

The epidemic of 1886, was one of the severest expe- 
rienced in the colony in many years. Between the months 
of April and October, one hundred Europeans died at Free- 
town. (Lamprey, loc. cit.) 



/- 



SIERRA LEONK — 1866-1872. 3«5 

In the Report for 1866, (published in 1868), pp. 204-256, 
it is stated that the squadron of the West Coast of Africa, 
consisted for 1866, of twenty-three vessels, with a mean 
force of 1,680 men. There were 519 cases of fever of a 
continued type or remittent type ; 30 cases of yeiloiv fever; 
87 of ague. Died: Five cases of primary fever; 25 of 
yellow fever; one of ague. The average duration of each 
case of yellow fever was about seventeen days. The aver- 
age duration of the fatal cases 4.3 days. 

In the epidemic on the ship Bristol, 1865-66, the first 
case occurred December 28, 1865; the first death, January 
3, 1866. Last case, January 11, 1866; last death, Feb- 
ruary 8, 186^. 

One case reported from the ship Espoir occurred about 
May 9, 1866, died May 14th. 

The epidemic on the ship Bristol was. derived throuirh 
communication with the ship Isis^ which was thoroughly 
infected with the disease. 

The Report gives two deaths from that disease on the 
Isis. One of them was taken ill on December 29, 1865, 
died January 1, 1866. The other took sick January 2, 
1866, died January 7th. This was the last of the series 
of cases that occurred in the Isis. 

Twenty-eight cases occurred on the Bristol, one on the 
Espoir, and one on the Isis. Of these, 25 proved fatal. 

1868. 

The year 1868, witnessed another outbreak at Freetown. 
(Berenger-Feraud, page 144.) The exodus of the unac- 
climated Europeans prevented the disease from becoming 
epidemic. 

1872. 

For four years. Sierra Leone had a reprieve from yellow 
fever. In 1872, the disease reappeared at Freetown. It 
was of a particularly malignant type, the mortality being 
especially high in May, June and July. Even as late as 
December, six deaths are recorded. The average death- 



326 HISTORY OF YELLOW FEVER 

rate in Freetown during 1872, was 250 per 1,000. This 
excessive mortality does not include all the victims of the 
pestilence, as many died on shipboard in trying to escape 
from the colony.^^ 

1878, 

Six years of immunity is credited to Sierra Leone, but 
whether deserved or not, we cannot say. In 1878, the 
fever reappeared and caused some mortality. The disease 
was present in many parts of Western Ajfrica that year, 
notably in Senegal, Gambia and even in Soudan. 

1884. 

The epidemic of 1872, and the outbreak of 1878, had no 
doubt decimated the non-immune population of Sierra 
Leone, and the fear of falling victims to the climate had 
been instrumental in keeping away emigration, for we find 
no record of the appearance of yellow fever from 1878 to 
1884. The epidemic of 1884, began in May. One of the 
peculiarities of the disease, is that it attacked the natives 
in great numbers. The average death rate among the 
blacks was 35 per 1,000 per month, while the death-rate 
among the Europeans was six per cent, for the same 
period. The fever was most severe in June and July, and 
declined with the maturity of the rains in August. It 
gradually decreased until December, when it totally dis- 
appeared.^^ 

Conclusions. 

From 1884, to the present time (1908), a period of 
twenty-four years, there is no record of yellow fever hav- 
ing prevailed in Sierra Leone. This immunity is no doubt 
due to the fact that the British Government, profiting by 
the terrible experiences of the past, garrisons its posts 

^^ Lamprey, loc. cit. 
®® Lamprey, loc. cit. 

®^ Army Medical Department Report for tlie Year 1886, 
(London, 1888), p. 79 



SOUDAN. 327 

with black troops, whose immunity from yellow fever is 
proverbial. For example, in 1886, the garrison at Free- 
town consisted of 340 African soldiers, commanded by 
hardly half a dozen white officers. The mortality for the 
entire year among these 340 blacks, from all causes, 
amounted to only six. 

SOUDAN. 

Description. 

Soudan is a country in Central Africa, south of the 
Desert of Sahara, and extending from the Atlantic Ocean 
to the Eed Sea. This is the home of the true negro race, 
and is for the most part inhabited by degraded savages. 
Its area is estimated at 2,000,000 square miles, and its 
population from 8 to 30 millions. Arab colonists and 
traders form a large part of the foreign population. On 
the Atlantic seaboard, the French have established a col- 
ony, but, with the exception of prospectors, soldiers and 
laborers employed on the railroad from "Kayes to Kita, 
no Europeans are to be found in this vast region. Tim- 
buctoo, the capital, is far from being an ideal place. It 
is miserably built, in a wretched country, situated amid 
burning and moving sands, on the verge of a morass. 
There are a few brick houses, but most of the dwellings are 
mere circular huts of straw and earth. Population, 
12,000, principally natives, with some Moors. 

YELLOW FEVER YEARS. 

1828; 1829; 1878; 1879; 1880; 1881; 1882; 1891; 1892; 
1897; 1901; 1902; 1903; 1907. 

SUMMARY OF EPIDEMICS. 

1828-1829. 

The history of yellow fever in Soudan, begins with the 
first attempt of the white man to penetrate into that in- 



328 HWTORY OF YELLOW FEVER. 

salnbrious region. A" : i :i^_ : B>yle.-- rhe epidemic of 
yellow feyer which ravage! >i :: L- ::, in 1829, first 
made its appearance in Sri: r n. a counrry in the in- 
terior, about thirty days' i in a northeast direction 
from Medina. The fcTer - at Sangarrah abont 
Christmas, 1828. It is said :^:.7 i^ re chiefs were stricken 
that year than erer before. Sangarrath is a low marshy 
conntry, covered with jnngle. Bantoe, lying in the sonth- 
west of Sangarrah, is also said to have suffered exceed- 
ingly. Out of twelve men sent out in March, to hunt 
elephants, only one returned alive, the others having died 
in the forests. Between Sangarrah and Footah Jallon, 
whole villages were said to have been depopulated. 

From Laheer and down through the Mandingo country, 
traveling in a southwest course to Fouricaria and Melicor- 
ree, the number that died was unprecedented. In the vil- 
lage of Tongroo, the mortality was excessive. From fur- 
ther and rather extensive inquiries of the natives from 
various parts of the main land, it was ascerirained that the 
fever prevailed among the tribes of the following local- 
ities: Bnlam. Pori:o Lago, KokeUe, Scarcies, MeUacoree 
and Foolah. 

Those from whom these statements were obtained, were 
unanimous in the opinion that the disease proceeded from 
the eastward. It was greatest in the neighborhood of 
Pori:o Lago, and down to the swampy tongue of land which 
separates Porto Lago from the Small Scarcies, and across 
the country to MeUacoree and Forrecarreah. 

From mes.sengers from Timbo, in the b^inning of 
August, it was ascertained that an epidemic prevailed there 
twelve months previously to that date (1829), and that 
it had then ceased only four months. The complaint was 
described ]>y these per>ple as being attented with pains in 
the head, back and loins, with hot skin and black tongue. 
In the advanced stage of the disease, the gums and tongue 
exhibited the color of blood; and it was added that some 
threw up a black fluid like a mixture :f i "wder. 

"Boyle: A Practical Medico-Historical Account of the Wes:- 
em Coast of Africa, etc. 1831. p. 255. 



SOUDAN — 1828-1829. 329 

Origin of the Epidemic. 

The Timbo people believed that the sickness took its 
origin in the attempt at clearing a swamp in the neighbor- 
hood of Timbuctoo, and that it thence spread to Jenne, 
from Jenne to Footah Tauro, and thence to Footah Jallon. 
It was also said to have prevailed at Tamassoo, Tambacca 
and Kissy-Kissy. 

Boyle's assertion that the epidemic first made its ap- 
pearance in the interior, cannot be seriously entertained, 
for yellow fever is not an African product, being always 
imported or caused by the renewed activity of infected 
mosquitoes who have survived the rigors of the winter- 
season. Timbuctoo, which is near the southern border- 
line of the Desert of Sahara, is totally deficient in natural 
products, and provisions for the sustenance of its inhabi- 
tants come chiefly from Jenne, on the Niger, about 300 
miles southwest of the capital. Timbuctoo is also the 
entrepot for the trade between Guinea, Senegal, Sierra 
Leone and North Africa, and in this way, should yellow 
fever be prevalent in Gambia, Senegal or Sierra Leone, 
it could easily be imported to Bakel, Medina or Kayes by 
way of the Senegal River, and from Kayes, by caravans, 
to the interior. 

In 1828, the railroad from Kayes, the head of naviga- 
tion on the Senegal, to Kita, another important town of 
French Soudan, had not been built, and the infection was 
probably carried by caravans, which acting as a firebrand, 
successively contaminated every village it passed through, 
finally infecting the capital itself. The first cases, as is 
always the case, and especially so in a savage country, 
were unrecognized, and when the epidemic became wide- 
spread, Timbuctoo was naturally accused of being the 
original focus. It is a notorious fact, that, even in this 
present era, when an epidemic of yellow fever breaks out 
in a locality where the disease prevails only accidentally, 
the original mode of infection is generally disputed and 
rarely settled to the satisfaction of the disputants. The 
New Orleans epidemic of 1905, is a glaring modern exem- 
plication of this assertion, for up to this day, over three 



330 HISTORY OF YELLOW FEVER. 

years after the incident, controversies are still rife as to 
how, when and where the ''first cases" originated. 

It is of no mlaterial importance to this generation or to 
generations to come, whether an epidemic of yellow fever 
which took place over a century ago in an unknown coun- 
try was imported or not ; but we cannot resist the tempta- 
tion of taking a dig at the assertion that the disease origi- 
nated in Central Africa, and try our hand at convincing 
our readers of the contrary. 

1878. 

Almost half a century elapsed before we again hear of 
yellow fever in Soudan. In this instance, however, the 
importation is clearly proved. 

In 1878, yellow fever prevailed extensively along the 
West Coast of Africa, and was especially severe in Sene- 
gal. While the epidemic was raging along the banks of 
the lower Senegal Kiver, the French government, becom- 
ing aggrieved at the conduct of certain chiefs inhabiting 
the western borders of Soudan, fitted out a punitory force 
at Saint Louis, the capital of Senegal. The history of 
this" expedition, which is detailed in our account of the 
epidemic of 1878, in Senegal ( q. v. ) , is certainly a sorrow- 
ful one. Of 317 Europeans who took part in the expedi- 
tion, 180 fell victims to yellow fever. The travel of the 
invading fleet up the Senegal Elver reminds us of the 
case of the James D. Porter, which, that same year, suc- 
cessively infected every city and town it stopped at in its 
memorable journey up the Mississippi Elver from New 
Orleans to Gallipelis, a distance of over a thousand miles. 

The spread of the disease by the invading column is 
minutely narrated by Lejemble.^^ 

The first place to be infected was Bakel, an important 
mart on the upper Senegal Eiver, three hundred and fifty 
miles from Saint Louis. It is a walled town of about 
8,000 inhabitants, and has a large stone fortress, where a 
French garrison is permanently maintained. 

^'Lejemble: Epidemiologie de la Fievre Jaune au Senegal 
Pendant I'Anne 1878. Paris, 1882. 



SOUDAN — 1878 331 

A physician from Goree, who arrived at Bakel on July 
28th, is accused of having brought the infection to that 
village. Be that as it may, the first case at Bakel was 
observed on August 12th, followed by death on the 16th. 
At that time, the garrison of Bakel consisted of only eight 
white soldiers. When the last case died, September 11th, 
there was only one left. All the others had paid tribute 
to the terrible scourge. 

When the punitory column reached Bakel four days 
after leaving Saint Louis, yellow fever had already in- 
vaded its ranks. Those who were too weak to proceed, 
were left at the village and the transports proceeded on 
their way up the Senegal Eiver. Of the sick left at Bakel, 
ten died with black vomit, between September 15th -and 
October 27th. This makes a total of seventeen deaths in 
the village from August 12th, to the end of the epidemic. 

After leaving Bakel, the expedition passed through 
Kayes, but there is no record of any cases at that post. 

Medina, the next important post, east of Bakel, on the 
Senegal Elver, was less fortunate. A few days after the 
passage of the column, yellow fever broke out in the vil- 
lage, and from September 20th to October 11th, there were 
twelve deaths among the sparse white j)opulation of the 
place. 

The soldiers, although sick and discouraged, gave battle 
to the tribesmen, on September 22, 1878, near Saboucire, 
a town oh the borders of French Soudan. It was more of 
a slaughter than a battle, for the natives rapidly gave way 
to the French, and the conflict lasted hardly an hour. 
The return homeward was immediately begun, with results 
already depicted in our account of the epidemic of 1878, 
in Senegal. 

The soldiers did not originally bring the fever to Bakel, 
as seven deaths had already taken place at that post when 
the fleet carrying the column arrived, but the other places 
in Soudan were undeniably infected by the soldiers. Bakel 
and Medina are the only places in Soudan where a record 
of the deaths from yellow fever in 1878 was kept, but 
there is no doubt that the disease prevailed at Kayes and - 
the other places along the banks of the Upper Senegal 
and its branches. 



33J HISTORY OF YELLOW FEVER. 

1879. 

In 1879, only a few cases were observed, of which no 
record was kept. 

1880. 

In 1880, cases broke out among the laborers employed 
in building the railroad from Kayes to Kita. The fatal- 
ities were few. 

1881. 

In 1881, the fever was brought into Soudan by the 
troops under Colonel Desbordes, and prevailed quite ex- 
tensively. The colonial health authorities wanted to seg- 
regate the infected battalions, but the home government 
positively refused to sanction such a movement, and the 
malady was allowed free play. The column continued its 
march, spreading the infection everywhere it stoj)ped. 
The malady finally subsided for want of new material. 
Medina, as usual, suffered considerably. No official record 
was kei^t of the cases and deaths. 

1882. 

In 1882, the troops again brought the fever into Soudan. 
The chief victims that year were Chinese and Moroccan 
laborers employed on the railroad. They were buried, 
like dogs, along the railroad embankment. Official 
records are silent concerning the extent of this outbreak. 

It is a remarkable fact that every history of the appear- 
ance of yellow fever in Soudan, since 1878, presents about 
the same characteristics: That it has never gone beyond 
its primitive limits, but has always shown itself on the 
railroad between the towns above mentioned. This can 
no doubt be accounteed for by the fact that new-comers 
were constantly arrivinsj to take the place of the laborers 
who had been mowed down by the disease, and as they 
only came from tme to time and were few in number, they 
slowly fed the fires of contagion. This view is reinforced 
by the fact that cases generally cropped out shortly after 
the arrival of imj^orted laborers. 



SOUDAN — 1891. S33 

It is also a curious fact that the Moroccans and Chinese 
who are largely used in works of construction in Western 
and Central Africa, are even more susceptible to yellow 
fever than the whites. The poor fellows die like flies when 
an epidemic breaks out in Soudan and their bones literally 
strew the line of railroad from Kayes to Kita, which was 
built at a cost of thousand of lives. 

1891. 

In 1891, there was a sudden influx of Europeans into 
French Soudan, and yellow fever was again imported into 
that region. 

The first news of the prevalence of the disease reached 
colonial headquarters on October 17th, 1891, when a tele- 
gram was received announcing that the caravan which 
had left Medina, on October 6th, under military escort, 
had reached Kita in a deplorable condition.^^ During the 
journey, ten soldiers had died from various causes. The 
doctors who accompanied the caravan, attributed this un- 
usual death-rate to the fierce rays of the sun and fatigues, 
but Dr. Primet, chief health officer of the colony was far 
from satisfied with this diagnosis and requested that a 
clinical history of every man who had died be telegraphed 
to headquarters. In spite of the vagueness of these details 
and the continued reiteration of the attending physicians 
that the sun and fatigues were responsible for the state of 
affairs. Dr. Primet came to the conclusion that these 
deaths were the results of a common cause, and strongly 
suspected an outbreak of yellow fever. These suspicions 
were communicated to the physicians of Kita, which ap- 
peared to be the center of infection, but the hypothesis 
was regarded as preposterous by these gentlemen, and the 
reigning malady declared to be an aggravated form of 
typho-malaria. 

Dr. Primet desired to make an issue of the matter, and 
determine by investigation if an epidemic of some sort 

*** Primet: Archives de Medecine Navale, Paris, 1893; Vol. 59, 

pp. 357, et seq. 
"Primet: Loc. cit. 



334 HISTORY OF YELLOW FEVER. 

was not prevalent at Kajes, the original point of depart- 
ure of the caravan, but the colonial goyernment, fearing 
that a panic would ensue ^ould publicity be given to the 
matter, protested against the institution of such measures, 
unless undeniable proofs be furuished of the existence of 
an unusual disorder in the suspected j)laces. ^N-everthe- 
less, secret instructions were sent to the physicians of 
Kayes, Kita and other towns in the suspected zone, en- 
joining them to take extraordinary xDrecautious and to iso- 
late all the cases of typho-malar'a or continued fever. 

These half-hearted precautious did not improve the sit- 
uation. Other localities successively gave evidence of 
abnormal health conditions. Two cases of ^'bilious hema- 
turic fever" appeared at Koudou, followed by one fatality. 
At Segou, many cases of the same malady proved fatal, 
and two army officers were attacked at Sigiiiri. One of 
these died. At Medina, an unusual number of cases of 
typho-malaria prevailed. At Bafoulabe, the situation be- 
came more serious. Cases of '^pernicious fever" became 
daily more frequent until October 30th, when the occur- 
rence of black vomit in some cases left no doubt as to the 
nature of the disease. 

But the government was skeptical; it wanted a ^'posi- 
tive" case. A few days afterwards, a workmen, originally 
from Bafoulabe, was admitted into the hospital, at Kayes, 
suffering from '^continued fever." He died two days later, 
and the autopsy revealed undeniable lesions of yellow 
fever. 

This i3ositive case gave Dr. Primet the entering wedge 
he was waiting for, and he immediately appealed to the 
commandant of the colony to institute rigorous measures. 
He pointed out that it was undeniably yellow fever which 
was decimating the troops, and that grave consequences 
would follow if the convoys which were on their way to 
Kita were not prohibited from going farther into the in- 
terior. In short, it was imperative to arrest the progress 
of the malady at Kita. 

Wishing to study the situation himself, Dr. Primet left 
for Bafoulabe. On his arrival, he made a rigid examina- 
tion, which confirmed his reiterated assertions that the 



SOUDAN — 1891. 335 

gOYernment was face to face with an epidemic of yellow 
feyer. Orders were at last received to resort to stringent 
measures to prevent the newly-arrived soldiers from be- 
coming contaminated. These instructions, although tardy, 
saved the new arrivals from being decimated. The gov- 
ernment was deploying 300 men in the region, and the 
turning away of the soldiers who were marching to the 
field of operation into less frequented roads and by-ways, 
although, tedious and attended with more hazards, proved 
their salvation. The malady was confined to the troops 
and laborers already in the infected zone. The beneficial 
results of strict attention to sanitary rules and isolation 
from infected centers was clearly proved by the fact that, 
during the three months which the invading column took 
to reach the scene of active military operations, only three 
cases of sickness took place and not a single death 
resulted. 

In the infected region, the situation was daily getting 
worse. It was too late to arrest the progress of the dis- 
ease. The criminal negligence of the government had 
<laused the poison to be so widely diffused, that cases 
erupted at nearly every place on the Kayes-Kita railroad. 

A convoy which had started from Kayes, on October 
25th, for Niore, consisting of thirty-five Europeans, under 
the command of a captain of dragoons, lost seven men by 
yellow fever three days after passing through Medina, and 
a few days after reaching Niotre. 

Another convoy, which had left Bafoulabe the day after 
the arrival of Dr. Primet, passed through Badumbe, on 
November 16th, where it left four sick soldiers, who all 
died between the 21st and 28th of September, with unde- 
niable symptoms of yellow fever. 

A lieutenant en route to the Niger, arrived at Kita, on 
November 5th, and died with black vomit on the 9th. 

At Bakel, one death on November 4th, followed by three 
more shortly after. 

It would be tedious to follow the progress of the disease, 
as it everywhere presented the same characteristics. The 
appended table will give an idea of its ravages among the 
small European population, principally soldiers and rail- 
road laborers, from October 27th to December 31st, 1891: 



NOY. 


Dec. 


Toti 


7 


2 


15 


5 





5 


1 


3 


4 


3 





3 


3 





12 








1 


5 





5 


11 





11 



3S6 HISTORY OF YELLOW FEVER. 

Locality. Oct. 

Bafoulabe 6 

Bedumbe 

Bakel 

Kayes 

Kita 9 

Kondou 1 

Medina 

Nioro 

16 35 5 56 

The greatest mortality took place in November, when 
thirty-five deaths are recorded. The isolation of the troops 
from the foci of infection left the disease without fresh 
material, and cases occurred at rare intervals until Jan- 
uary 8th, when the last death took place. 

Origin. 

Dr. Primet accuses Medina of being the focus whence 
radiated the Soudanese epidemic of 1891-1892. This town 
will be remembered as the one which suffered the most 
during the great epidemic of 1878, only one European 
being left alive after the subsidence of the malady. In 
1878, Medina was infected by the Logo Expedition, which 
left a trail of deaths and desolation from Saint Louis to 
Sabourcire ; but, in 1891, although an expedition was sent 
against the natives by the French government, there was 
no yellow fever in Senegal, and the invading column can- 
not be incriminated. How, then, did Medina become in- 
fected? 

A reference to our chronological tables will show that 
Bonny was the only locality on the African Coast where 
yellow fever prevailed in 1891. In the beginning of that 
year. Bonny was put under quarantine by the other Afri- 
can colonies, but the fever finally disappearing, quaran- 
tines were raised on April 10th. Bonny is an English 
colony, and the commercial relations between that point 
and Senegal are very active. It is well-known that the 
natives of the interior, especially the Soudanese, for some 



SOUDAN — 1891-1892. 3.^7 

undefined reason, prefer articles of English manufacture, 
such as calicoes, leather, woolen goods, etc., and that 
native courriers and Sjirian and Moroccan peddlers do an 
extensive importing business, often a la legere. In addi- 
tion to these smugglers, the river-boats bring annually a 
large amount of freight up the Senegal Eiver to Kayes, 
the head of navigation, whence the goods are distributed 
to the innumerable towns and villages on the railroad 
from Kayes to Kita. Beyond Kita, caravans bring the 
products to Timbuctoo. 

It will be argued that the distance between Bonny and 
Kayes, is too great to admit of importation, but it must 
be borne in mind that the coasting-vessels plying along the 
coast are built so as to make swift and fcequent voyages, 
being equipped with the latest machinery, and that they 
lose no time in their journey up the Senegal. Mosquitoes 
infected at Bonny, could thus easily have been transported 
to Medina, where their liberation created the focus which 
finally infected the several localities mentioned in this 
history. 

Primet does not take kindly to the hypothesis of im- 
portation, but believes that the outbreak was caused by 
the reviviscence of the germs of the epidemic of 1881, 
which was more severe at Medina than anywhere else in 
Western Africa. The bugaboo of repullulation of germs 
seems to be firmly imbedded in the writings of most 
French authors. Even as late as 1903, we find this unten- 
able opinion promulgated by some of the most eminent 
French epidemiologists, although, the doctrine first 
launched by Finlay, in 1883, and corroborated by innu- 
merable experiments, should leave no doubt in the mind 
that the mosquito theory is the only sensible one. 

1892. 

Only four cases of yellow fever were observed in Sou- 
dan in 1892. 

On January 8th, two cases, followed by death, occurred 
atBakel. 

In January a fatal case erupted at Kita. 



338 HISTORY OF YELLOW FE%T:ER. 

On March 30tb a case was reported at Bafoulabe, ^'^ 
the person of a brigadier of artillerT who had recently 
arrived. The patient recovered. 

The French government tardily resorted to the wise ex- 
pedient of not sending non-immiines to the localities af- 
fected by the epidemic of 1S91. and the outbreak of 1S92 
was confined to these four cases. As they occurred solely 
among new arrivals, they may be considered merely as 
echoes of the extensive ejjidemic of the previous year. 



189' 



From January. 1S92. to September. 1S97. yellow fever 
was kept out of Soudan. This immunity was no doubt 
dne to the fact that the disease did n:.T prevail in the 
Lower Senegal Valley, and that the movement of the 
French trooi>s were not ver-y active during that peri(xl. 

The fir-st ca.se was observed at Talary. a military post 
on the Kayes^Kita railroad, between Galongo and Bafoul- 
abe. The victim was taken sick September 20th. and died 
on the 24th. 

On October Sth. a railroad foreman died on a train be- 
tween Galongo and Talary. while on his way to the hos- 
pital, at Kayes. He had been confined to his bed since the 
5th of the month. 

The third case occurred at Mahina. a village on the 
railroad, a few days later, in the I:^erson of an army ser- 
geant, who died on the 15th. 

Three deaths within as many weeks, from undoubtedly 
a common cause, aroused the suspicions of Dr. Auvray. 
chief health officer, who fitted out a special train and went 
to Mahina to make a personal examination of the situa- 
tion. 'VMiile th^ lesions were decidedly suspicious, the 
doctor hesitated to pronounce it a case of yellow fever, as 
that diesease had not been observed in Soudan for the 
past five years. He afterwards admitted, when the malady 
became epidemic, that this and the other cases were unde- 
niably manifestations of yellow fever. 

On his return from Mahina. Dr. Auvry stopped at Dia- 
mou, which is mid-way between Talary and Kayes. where 



SOUDAN — 1897. »S9 

he took in charge a soldier who had been ill for two days 
previously. This patient was transported to the hospital 
at Kayes, where he died on the 18th. The autopsy re- 
vealed the identical lesions which had been found in the 
case of the army sergeant. A diagnosis of yellow fever 
was withheld, however, as the doctor feared the conse- 
quences wh'ch would follow the publicity of such an an- 
nouncement. 

On October 19th two cases were admitted into the hos- 
pital, one from Galougo and the other from Mahina. The 
first case died on the 22nd, the second on the 23rd. 

October 16th, a Catholic missionary died, at Dinguira. 

The death of the missionary was so undeniably due to 
yellow fever, that the diagnosis was given publicity. 
When the news reached Senegal, a strict quarantine was 
inaugurated against Soudan, and the movement of troops 
ordered stopped until the subsidence of the epidemic. 

The government had not forgotten the terrible lesson of 
1891. 

October 20th, a fatal case at Kale. 

October 31st, two cases admitted into the hospital at 
Kayes, one from Galongo and the other from Mahina. 
Both recovered. 

November 2nd, a case erupted at Dioubeda. The patient 
died on the train while being transported to Kayes. 

On November 2nd, a priest died at Kita. 

On November lOth, a case erupted at Diamous. The 
patient was transported to the hospital, at Kayes, where 
he recovered. 

On November 10th, occurred the first case at Kayes. 
The patient was an army sergeant who had gone to Corin- 
ville, on November 4th, where he remained until the fol- 
lowing day. On his return, he had stopped at Diamou, 
where he probably contracted the disease. He died No- 
vember 13th. 

November 12th, second case at Kayes, followed by death 
on the 19th. 

The epidemic seemed to end with the death on the 19th, 
and no new cases being observed for two weeks, Senegal 
raised the quarantine which had been instituted against 
Soudan. The medical constitution of the dependency ap- 



340 HISTORY OF YELLOW FEVFR. 

peared to have resumed its nomal condition, when a case of 
yellow fever suddenly erupted, at Kayes, on December 6th, 
in the person of the assistant commissary- of the town. 
On the same day, two patients who had been under treat- 
ment at the hospital for simple fever, suddenly showed 
suspicious symptoms and were placed under close ob- 
servation. 

The three cases above cited terminated fatally, the first 
on December 8th, the second on the 9th, and the third on 
the 15th. 

A mild case, followed by rapid recovery, was observed 
a few days later, at Kayes. This was the last echo of the 
epidemic of 1897. 

Statistics of the Epidemic of 1897. 

The fatalities of the epidemic of 1897 were few, because 
the European population was small. There were only 
eighteen whites employed along the railroad. These fur- 
nished fourteen cases' and ten deaths. There were six 
cases and four deaths among the soldiers. Xo mention is 
made of the course of the disease among the Chinese and 
Moroccans, who generally die like flies whenever an epi- 
demic of any sort prevails in the Soudan, be it yellow 
fever, malaria or typhoid. Out of a total of twenty-five 
cases, there were nineteen deaths, fourteen on the Kayes- 
Kita railroad and five outside of the infected zone. The 
deaths were distributed as follows: 
Locality. Sept. Oct. Nov. Dec. TotaL 

Diamou . 1 1 

Dinguina 1 1 

Diobede 1 "'o 1 

Galongo 10 1 

Kale 2 2 

Kayes 1 3 4 

Kita 1 1 

Mahina 1 1 

Talary 1 1 2 

Total on Kayes- 

Kita Railroad. 1 9 1 3 14 

Unclassified 5 

Total deaths .... 19 



SOUDAN— 1897. 341 

Origin. 

The origin of the epidemic of 1897 is shrouded in 
mystery. As no eases had been observed for over five 
years, the genesis of spontaneity can certainly not be sus- 
pected. Auvray and Boury,^^ from whose account the 
salient facts of this epidemic are taken, following in the 
trend of the majority of French writers, argue in favor 
of the telluric origin of the epidemic. The theory of 
evolution of the yellow fever germ promulgated by these 
learned gentlemen is certainly remarkable. According 
to their way of reasoning, yellow fever is produced by 
a microbe which, continuing to evolute in the cadaver, 
finally invades the surrounding earth, which becomes an 
immense culture^field, where the organism develops, until 
it either arrives spontaneously at the surface or is accel- 
erated into virulent activity by being dug out from its 
cachette by the profane hand of man. Once at the sur- 
face, the germs circulate at will, spreading the infection 
far and wide. The digging of the soil along the line of 
the Kayes-Kita Eailroad, where are inhumed thousands 
of yellow fever victims, is given as the active cause of the 
epidemic of 1897. 

The theory of spontaneity being untenable, where are 
we to- look for the source of infection? There was no 
yellow fever in Senegal ,in 1897. As Soudan has always 
been contaminated by Senegal, we must look elsewhere. 
But where? A search through consular reports and 
ofi&cial records fails to bring to light a single case of yellow 
fever on the Western Coast of Africa, in 1897; but, of 
course, this does not mean that yellow fever was not 
present and the fact offlcially suppressed. The ways of 
colonial governments, like those of the Heathen Chinese, 
are dark and tricky. The political history of the African 
colonies demonstrates that hygienic regulations are sub- 
servient to commercialism, no matter what the risk may 
be. The penalty for this transgression has often been 
severe, but mammon worship closes the eyes to past events 

®^ Auvray aaid Boury: Annales d'Hygiene et de Medecine Colo- 
niales, 1898, vol. 1, p. 433, et ceq. 



342 HISTORY OF YELLOW EVER. 

and the same thing happens again and again. 

How the fever was imported into Soudan in 1897, will 
therefore remain hidden behind the mists of conjecture. 

1901. 

The year 1901 witnessed another outbreak of yellow 
fever in Soudan. There were many cases, but the deaths 
were not numerous. 

1902. 

The first cases in 1902 were observed about October 
1st, in the same localities as in 1897 and 1901. There 
were altogether fourteen cases and ten deaths. Five of 
the deaths occurred at Kayes and five along railroad.^^ 

1907. 

After five years of respite, yellow fever again made its 
appearance in Soudan, among the same localities visited 
by previous epidemics., in November, 1907. The epidemic 
was attended with the usual heavy percentage of mor- 
tality. Between November 1st and 30th, a total of thirty- 
cases, with sixteen deaths, were reported.^^ 

We have not been able to ascertain the source of the 
outbreak. 

1908. I 

We had thought that the epidemic of 1907 would close 
the history of yellow fever in Soudan, so far as our work 
is concerned, but, "as we go to press," to use the favorite 
expression of up-to-date journalism, we are informed by 
consular reports that the disease has again broken out in 
Upper Senegal Valley. Drastic preventive measures are 
being taken by the French government, and we hope 
that the invasion will be throttled in its incepiency. 

We have noi means of ascertaining, at this late date, 

^^Kermorgant: Annales d'Hygiene et de Medicine Coloniales, 

1904; vol. 7, p. 405. 
•*U. S. Public Health Reports, 107; vol. 2, p. 156. 



SOUDAN — 1908. 343 

how the fever was imported into Soudan, in 1907-1908, 
but as every outbreak in the past has co-incided with the 
movements of the French troops from Senegal into the 
interior, we have no' doubt that the same thing happened 
in this instance. The disease has never manifested itself 
outside of the zone usually traversed by these troops, and 
in only one instance (1828) has it been observed further 
east than Kita, until very recently the terminus of the 
railroad. The epidemic of 1828-1829 (q. v.) may be con- 
sidered as an anomaly, which has never been duplicated 
and probably never will be, unless the white race, blind to 
the folly of such an act, should attempt to permanently 
occupy this insalubrious region. 



CHRONOLOGY OP YELLOW FEVER IN AFRICA 

AND THE ISLANDS OFF THE COAST 

THEREOF, FROM 1494 TO 1907. 

Fifteenth Century. 

First Appearance of Yellotv Fever off the Coast of Africa, 

1494. Canary Islands. 

1495. Canary Islands. 

1496. Canary Islands. 

1497 to 1509. Period of Immunity. Thirteen Years, 

Sixteenth Century. 

1510. Cape Verd Islands. 

1511. Cape Verd Islands. 

1512. Canary Islands, Cape Verd Islands. 

1513. Cape Verd Islands. 

1514. Cape Verd Islands. 

1515. Cape Verd Islands. 

1516 to 1519. Inmwwnity, Four Years. 
1520. Benin. 

1521 to 1530. Immunity. Ten Years. 
1531. Canary Islands. 

1532 to 1552. Immunity. Twenty-one Years. 
1553. Benin. 

1554 to 1557. Immunity. Four Years, 

1558. Saint Thomas Island. 

1559 to 1581. Immunity. Twenty-three Years. 
1582. Canary Islands. 



AFRICA. CHRONOLOGY 1494 TO 1907. 345 

1583 to 1587. Immunity. Five Years. 
1588. Benin, Saint Thomas Island. 

1589 to 1598. Immunity. Ten Years. 
1599. Canary Islands. 

Seventeenth Century. 
1600. Immunity. One Year. 

1601. Canary Islands. 

1602 to 1605. Immunity. Four Years. 
1606. Canary Islands. 

1607 to 1638. Immunity. Thirty-two Years. 
1639. Cape Verd Islands. 

1640 to 1700. Immunity. Bixty-one Years. 

Eighteenth Century. 
1701. Canary Islands. 

1702 to 1752. Immunity. Fifty-one Years. 
1753. Madeira Islands. 

1754 to 1758. Immunity. Five Years. 
1759. Senegal. 

1760-1761. Immunity. Two Years. 

1762. Gambia. 

1763. Sierra Leone. 

1764. Gambia, Sierra Leone. 

1765. Immunity. One Year. 
1766. Gambia,, Senegal, Sierra Leone. 



S46 HISTORY OF \t:llow fe\t:r. 

1767. Immunity. One Tear, 

1768. Gambia,. 

1769. Gambia, Senegal. * . . 

1770. Immunity. One Year. 

1771. Canary Islands. 

1772. Canary Islands. 

1773. Canary Islands. 

1774 io 1777. Immunity. Four Years. 

1778. Cape Verd Islands, Gambia, Gold Coast, Sene- 
gal, Sierra Leone. 

1779. Senegal. 

1780 fo 1785. Immunity. Siw Years. 
1786. Gold Coast. 

1787/^0 1791. Immunity. Five Yearns. 
1792. Bulam Island, Fernando-Po. 

1793 to 1803. Immunity. Eleven Years. 

XlXETEEXTH CeXTURY. 

1804. Morocco. 

1805 to 1806. Immunity. Two Years. 
1807. Cape Verd Islands, Sierra Leone. 
1808. Immunity. One Year. 

1809. Sierra Leone. 

1810. Canary Islands. 

1811. Canary Islands. 

1812. Fernando-Po, Sierra Leone. 



AFRICA CHRONOLOGY 1494 TO 1907. 34? 

1813 to 1814. immunity. Two Years. 

1815. Sierra Leone. 

1816. Congo Coast, Sierra Leone. 

1817. Immunity. One Year. 

1818. Alscension Island. 

1819. Sierra Leone. 

1820. Immunity. One Year. 

1821. Cape Verd Islands. 

1822. Cape Verd Islands, Gold Coast, Sierra Leone. 

1823. Ascension Island, Grold Coast, Sierra Leone. 

1824. Gold Coast. 

1825. Gambia, Sierra Leone. 

1826. Sierra Leone. 

1827. Cape Verd Islands. 

1828. Benin, Canary Islands, Gambia, Senegal, Sierra 
Leone, Soudan. 

1829. Fernando-Po, Senegal, Sierra Leone, Soudan. 

1830. Saint Helena, Senegal, Sierra Leone. 

1831 to 1836. Immunity. Siw Years. 

1837. Cape Verd Islands, Gambia, Senegal, Sierra 
Leone. 

1838. Ascension Island, Cape Verd Islands, Sierra 
Leone. [ 

1839. Fernando-Po, Sierra Leone. 

1840 to 1844. Immunity. Five Years. 

1845. Sierra Leone. 

1846. Canary Islands, Cape Verd Islands. 

1847. Ascension Island, Banana Islands, Canary 
Islands, Cape Verd Islands, Sierra Leone. 

1848. Sierra Leone. 

1849 to 1851. Immunity. Three Years. 

1852. Benin, Gold Coast, Ivory Coast. 

1853. Benin, Gold Coast. 

1854. Benin, Gold Coast. 



348 HISTORY OF YELLOW FEVER. 

1855. Benin, Gold Coast. 

1856. Benin, Gold Coast. 

1857. Benin, Fernando^Po, Gold Coast, Ivofry Coast. 

1858. Sierra Leone. 

1859. Ascension Island, Gambia, Senegal, Sierraj 
Leone. 

1860. Angola, Congo Coast, Fernando-Po, Gambia, 
Sierra Leona 

1861. Immunity. One Year. 

1862. Angola,, Benin, Bonny, Calabar, Canary Islands, 
Cape Yerd Islands, Congo Coast, Fernando^Po, Gold 
Coast, Ivory Coast, Sierra Leone. 

1863. Angola, Ivory Coast. 

1864. Cape Verd Islands, Fernando-Po, Lagos, Sierra 
Leone. 

1865. Angola, Gambia, Sierra Leone. 

1866. Fernando-Po, Gambia, Senegal, Sierra Leone. 

1867. Senegal. 

1868. Cape Verd Islands, Fernando-Po, Sierra Leone. 

1869. I^ernando-P^. 

1870 to 1871. Immunity. Twoi Years. 

1872. Senegal, Sierra Leone. 

1873. Ascension Island, Benin, Cape Verd Islands. 

1874 to 1877. Immunity. Four Years. 

1878. Gambia, Senegal, Sierra Leone, Soudan. 

1879. Senegal, Soudan. 

1880. Senegal, Soudan. 

1881. Bonny, Morrocco, Senegal, Soudan. 

1882. Senegal, Soudan. 

1883. Immunity. One Year. 
1884. Gambia, Sierra Leone. 



AFRICA. CHRONOLOGY 1494 TO 1907. 349 

1885 to 1887. Immunity, Three Years, 
1888. Canary Islands. 

1889-1890. Immunity. Two Years. 

1891. Soudan. 

1892. Soudan. 

1893 to 1896.- Immunity. Four Years. 

1897. Soudan. 

;1898. Gold Coast. 

1899. Ivory Coast. 

Twentieth Century. 

1900. Congo Coast, Gambia, Senegal. 

1901. French Guinea,, Senegal, Soudan. 

1902. Ivory Coast, Soudan. 

1903. Ivory Coast, Soudan. 

1904. Ivory Coast (on shipboard). 

1905. Canary Islands, Ivory Coast (on shipboard), 
Senegal. 

1906. Dahomey, Soudan. 

1907. Dahomey, Soudan. 



SUMMARY OF YELLOW FEYEE YEARS AND 

PERIODS OF IMMUNITY IN AFRICA, FOR 

FOUR HUNDRED AND FOURTEEN YEARS, 

1494 to 1907. 



Yellow Feyee Yeaks. 

1494-1496 3 

1510-1515 

1520 1 

1531 1 

1553 1 

1558 1 

1582 1 

1588 1 

1599 1 

1601 1 

1606 1 

1639 1 

1701 1 

1753 1 

1759 1 

1762-1764 3 

1766 1 

1768-1769 2 

1771-1773 3 

1778-1779 2 

1786 1 

1792 1 

1804 1 

1807 1 

1809-1812 4 

1815-1816 2 

1818-1819 2 

1821-1830 10 

1837-1839 3 

1845-1848 4 

1852-1860 9 



Pebiods of Immunity. 

1497-1509 13 

1516-1519 4 

1521-1530 10 

1532-1552 21 

1554-1557 4 

1559-1581 23 

1583-1587 5 

1589-1598 10 

1600 1 

1602-1605 4 

1607-1638 32 

1640-1700 61 

1702-1752 51 

1754-1758 5 

1760-1761 2 

1765 1 

1767 1 

1770 1 

1774-1777 4 

1780-1785 6 

1787-1791 5 

1793-1803 11 

1805-1806 2 

1808 1 

1813-1814 2 

1817 1 

1820 1 

1831-1836 6 

1840-1844 5 

1849-1851 3 

1861 1 



AFRICA. CHRONOLOGY 1494 TO 1907. 351 

1862-1869 8 1870-1871 2 

1872-1873 2 1874-1877 4 

1878-1882 5 1883 1 

1884 1 1885-1887 3 

1888 1 1889-1890 2 

1891-1892 2 1893-1896 4 

1897-1907 11 



Total Yellow Fever Total Years of Im- 
Years 101 munity 313 

Recapitulation. 

Yellow Fever Years 101 

Years of Immunity 313 



Total years under observation 414 



CHRONOLOGY OF YELLOW FEVER IN AFRICA, 
BY LOCALITIES. 

Angola— 1860, 1862, 1863, 1865. 

Ascension Island— 1818, 1823, 1838, 1817, 1859, 1873. 

Banana Islands — 1817. 

Benin— 1520, 1553, 1588, 1828, 1852, 1853, 1854, 1855, 
1856, 1857, 1862, 1873. 

Bonny— 1862, 1891. 

Bulani (Island of)— 1792. 

Calabar— 1862. 

Canary Islands— 1191, 1195, 1196, 1512, 1531, 1582, 
1599, 1601, 1606, 1701, 1771, 1772, 1773, 1810, 1811, 1828, 
1816, 1817, 1862, 1888, 1905. 

Cape Yerd Islands— 1510, 1511, 1512, 1513, 1511, 1515, 
1639, 1778, 1807, 1821, 1822, 1827, 1837, 1838, 1816, 1817, 
1862, 1861, 1868, 1873. 

Congo Coast— 1816, 1860, 1862, 1900. 

DahomeT— 1906, 1907. 

Fernando-Po (Island of)— 1792, 1812, 1829, 1839, 1857, 
1860, 1862, 1861, 1866, 1868, 1869. 

French Guinea— 1901. ' 

Gambia— 1762, 1761, 1766, 1768, 1769, 1778, 1825, 1828, 
1837, 1859, 1860, 1865, 1866, 1878, 1881, 1900. 

Gold Coast— 1778, 1786, 1822, 1823, 1821, 1852, 1853, 
1854, 1855, 1856, 1857,1862,1898. 

Guinea — {See Benin, Daliomey, French Guinea, Gold 
Coase, Ivory Coast, Lagos and Sierra Leone). 

Ivory Coast— 1852, 1857, 1862, 1863, 1899, 1902, 1903, 
1904, 1905. I 

Lagos— 1864. / 

Madeira Islands — 1738. 

Morocco— 1804, 1881. ] 

Saint Helena (on ship-board) — 1830. 

Saint Thomas — 1558, 1588. 

Senegal— 1759, 1766, 1769, 1778, 1779, 1828, 1829, 1830, 
1837, 1859, 1866, 1867, 1872, 1878, 1879, 1880, 1881, 1882, 
1900, 1901, 1905. 



AFRICA CHRONOLOGY 1494 TO 1907. 35S 

Sierra Leon^-1763, 1764, 1766, 1778, 1807, 1809, 
1812, 1815, 1816, 1819, 1822, 1823, 1825, 1826, 1828, 1829, 
1830, 1837, 1838, 1839, 1845, 1847, 1848, 1858, 1859, 1860, 
1862, 1864, 1865, 1866, 1868, 1872, 1878, 1884. 

Soudan— 1828, 1829, 1878, 1879, 1880, 1881, 1882, 1891, 
1892, 1897, 1901, 1902, 1903, 1906, 1907. 

YELLOW FEVEE VISITATIONS IN AFRICA, BY 
LOCALITIES. 

Y^ear of Year of 

Locality. First Last Total Number 
Appearance. Appearance, of Visitations. 

Angola 1860 1865 4 

Ascension Island .1818 1873 6 

Banana Islands. . . 1847 1847 1 

Benin 1520 1873 12 

Bonny ....1862 1891 2 

Bulam 1792 1792 1 

Calabar 1862 1862 1 

Canary Islands ..1494 1905 21 

Cape Verd Islands 1510 1900 20 

Congo Coast 1816 1900 4 

Dahomey 1906 1907 2 

Fernando^Po 1732 1869 11 

French Guinea ..1901 1901 1 

Gambia 1762 1900 16 

Gold Coaist 1778 1898 13 

Ivory Coast 1852 1903 9 

Lagos 1864 1864 1 

Madeira Islands .1738 " 1738 1 

Morocco 1804 1881 2 

Saint Helena 1830 1830 1 

Saint Thomas 1558 1588 1 

Senegal 1759 1905 21 

Sierra Leone 1763 1884 34 

Soudan 1828 1907 15 



Total number of yellow fever eruptions in 

Africa from 1494 to 1907 200 



354 HISTORY OF YELLOW FEVER. 

GENERAL STATISTICAL SUMMARY. 

Yellow Feyer ix Afeica and the Islands off the Coast 
thereof^ from 1494 to 1907. 

Total number of years under observation 414 

Yellow fever years 101 

Years of Immunity 313 

Total number of countries where the disease pre- 
vailed, either epidemically or sporadically 24 

Total number of yellow fever eruptions 200 

(The alleged eruptions of yellow fever in Egypt, 
Johanna Island and Madagascar, mention of which is 
made in our historical resume, are not included in the 
above tables, for the reason that we do not think they 
were manifestations of the disease under consideration. 
G. A.) 



HISTORY 



OF 



YELLOW FEVER 



IN 



EUROPE 



AUSTRIA. 

TEIESTE. 

Trieste, the only place in Austria, ever invaded by yel- 
low fever, is an important seaport at the head of the 
Adriatic Sea, seventy-three miles northeast of Venice, 
Italy. Population: 1870, 109,324; 1890, 158,344; 1907 
(estimated) 200,962. 

YELLOW FEVER YEAR. 
1894. 

Summary op Importation. 

iThe history of yelloAV fever in Austria is focused into 
a single importation of that disease. 

In 1894, the Italian steamship Colombo arrived at 
Genoa Italy, from Brazil. The captain reported having 
had yellow fever on the homeward trip. The vesisel was 
disinfected and allowed to land her passengers and cargo. 
Two of the crew, who lived in Trieste, took the train for 
their native town as soon as they were permitted to land. 
They were ill at the time, but no attention was paid to 
this by the Genoese authorities. On their arrival at 
Trieste, the two sailors were taken violently sick and 
removed to the hospital, where they died a few days later, 
with all the symptoms of yellow fever. 

vThe infection did not spread. 



Eager: Bulletin No. 8, Yellow Fever Institute, Washington, 
D. C, 1902, p. 33. 



AZORES. 

Description. 

The Azores, or Western Islands, are a group of nine 
islands in the Atlantic Ocean, 900 miles west of Portugal. 
Although, presumably discoyered by Gabral, in 1431, the 
Azores were evidently known to the ancients as they are 
m.ientioned by the Arabian geographer, Edrist, and are 
distinctly marked on a map of 1351. Punic coins found 
on the island of Goto, leads to the belief that the archi- 
pelago was visited by the Carthagenians. The islands 
belong to Portugal, and are a geographical part of 
Europe. Population, 270,000. Capital, Ponta Delgado, 
on the island of Sao Miguel. 1 

YELLOW FEVEE YEAR. 

1858. 

Summary of Importation. 

Although in the path of commerce between America 
and Europe, the Azores are seldom visited by merchant 
vessels. This is probably due to the fact that the archi- 
pelago has no good harbors. To this isolation, is no doubt 
due the almost total immunity of the group from yellow 
fever, for only a solitary invasion of the disease is 
recorded. i 

According to Avelino^ and Guimaraes,^ yellow fever 
was imported to Ponta Delgado by a vessel from Brazil, 
in 1858, under the following conditions : 

^ Pedro Alvarez Cabral, a Portugese navigator, was born about 
1460 and died in 1526. At the time be discovered the 
Azores, the islands were uninhabited and had scarcely 
any living things, except birds, particularly hawks. The 
Portugese called the whole group Azores, from "acor" 
or "azor," a hawk. 

^Avelino: Gaz. Med. de Lisboa, 1858, vol. 6, pp. 312; 327; 342. 

*Grimaraes: Ibid., p. 358. 



558 AZORES. 

On August 1st, 1858, two sailors, Eamao Jose and Jose 
Navio, arrived at Ponta Delgado from Lisbon, on the Bra- 
zilian ship Dots Amigos. Tlie men were in the first stages 
of yellow fever and were taken to the Hospital Misericor- 
dia. Jose died August 1th. Navio recovered and was 
discharged cured on August 27th. He embarked on the 
passenger packet Domingo, and was taken to the Cape 
Verd Islands, whence he returned to Lisbon, on the Dois 
AmigoSj, the same vessel which had brought him to Ponta 
Delgado. 

Avelino mentions a third case, that of a servant at the 
Hox)ital Misericordia, who was attacked on August 1th, 
the d.ay of the death of the first sailor. This case recov- 
ered, the man being well enough to resume his duties by 
August 12th. 

Avelino doubts that this third case was yellow fever, 
but as the patient had been in contact with the sick, his 
illness was classed as such.^ 

Grimaraes' article is far from being a gold mine of in- 
formation. He discusses Avelino's methods, but cites 
nothing which could throw additional light upon the sub- 
sequent history of this importation. 



° "A primeira e sgunda observacao nao me deixaram, nem a 
nenhum dos meus collegas acima mencionados, a menor 
duvida de que os doentes que fazem o objecto d'ellas 
foram ambos affectados de febre amarella. Foram dois / 
casos esporadicos. Nao pensamos, poreia, assim acerca 
do doente da terceira observacao. que persumimos 
ter apresentado os prenomenos que descrevi, por effeito 
de alguma disposicao gastrica, cujos symptomas morbidos 
foram despertados pelas causas occasionaes que as- 
signalei, auxiliadas mui provave^mente pelo terror." — . 
Avellino, loc. cit. 



FRANCE. 

Unlike her neighbor on the southwest, France does not 
occupy a prominent place in the annals of yellow fever. 
No cases have ever been known to originate on F'rench 
soil. The outbreak at Saint Nazaire, in 1861, and the 
sporadic eruptions in the other localities mentioned in 
this history were flagrant importations, and the manifes- 
tations of the disease on shore were traced in every in- 
stance to pensons who had communicated with vessels ar- 
riving from infected ports or who had come direct from 
localities where the Antillean pestillence was prevailing. 
The miniature epidemic of 1861, which caused the little 
town of Saint Nazaire world-wide notoriety, is the only 
serious manifestation of the disease under discussion 
which has ever invaded France. In every other instance, 
the malady was confined to the quarantine basins and laz- 
arettos of the seaports having direct communication with 
yellow fever foci. When a case occurred on shore, it was 
unequivocably traced to the above sources. The "cases 
presenting all the symptoms of yellow fever" which epi- 
demiologists claim to have observed in Paris, details of 
which are given in the history of yellow fever ais it con- 
cerns Paris, in this volume, were not manifestations of 
the disease. Of this, there can be no doubt, for reasons 
patent even to the most careless observer. 



360 HISTORY OF ^-ELLOW FEVER. 



CHRONOLOGY OF YELLOW FEVER IX FRANCE. 





1691 to 1908. 




1694. 


Rochefort (not autlientic). 




1696. 


Aix. 




1700. 


La Rochelle (not authentic). 




1802. 


Brest; Marseilles. 




1801. 


Marseilles. 




1807. 


Marseilles. 




1811. 


Bordeaux; Brest; Marseilles; Rochefort. 




1815. 


Brest. 




1820. 


Marseilles. 




1821. 


Marseilles; Montpellier. 




1822. 


Paris (not authentic). 




1823. 


Marseilles. 




1839! 


Brest. 




1815. 


Paris (not authentic). 




1856. 


Brest. 




1857. 


Xantes. 




1861. 


Havre; Montoir; Saint-Xazaire. 




1862. 


Saint-Xazaire. 




1870. 


Marseilles. j 




1881. 


Bordeaux; Dunkirk; Havre: Mindin; 


Saint- 


Kazaire. 






1883. 


Paris (not authentic), 




1891. 


Marseilles. 




1899. 


Bordeaux; Marseilles; Xantes. 




1900. 


Havre. 




1908. 


Saint X^azaire. 





FRANCE. 361 

By Localities. 

Aix. 1696. 

Bordeaux. 1811; 1881; 1899. 

Brest. 1802; 1811; 1815; 1839; 1856. 

Dunkirk. 1881. 

Havre. 1861; 1881; 1900. 

La Rochelle. 1700 (not authentic). 

Marseilles. 1802 ; 1804 ; 1807 ; 1811 ; 1820 ; 1821 ; 1823 ; 
1870; 1891; 1899. 

Montpellier. 1821. 

Mindin. 1881. 

Montoir. 1861. 

Nantes. 1857; 1899. 

Paris. 1822 ; 1845 ; 1883. (None of these alleged man- 
ifestations are authentic). 

Rochefort. 1694 (not authentic) ; 1811. 

Saint Nazaire. 1861 ; 1862 ; 1881 ; 1908. 

LOCALITIES IN FRANCE WHERE YELLOW 
FEVER HAS BEEN OBSERVED. 



Aix. A city in the department of Bouches-de-Rhoney 
seyenteen miles north of Marseilles. 

Bordeaux. A seaport, 358 miles southwest of Paris, in 
the department of Garonne (Guienne), on the Garonne 
River, sixty miles from its entrance intO' the Bay of Bis- 
cay. It has a large harbor, capable of containing 1,200 
ships. Population: 1875, 215,140; 1891, 242,259; 1907, 
(estimated), 253,000. 



362 HISTORY OF YELLOW FEVER. 

Brest. A city in the northwest extremity of France, 
department of Finistere (Bretagne), about 389 miles by 
rail, west of Paris. It is advantageously situated on the 
north shore of an arm of the Atlantic Ocean, called the 
Eoad of Brest. It is one of the foremost naval ports of 
Europe. Population: 1876, 66,828; 1891, 75,854; 1907 
(estimated), 85,263. ' 

Dunkirlv. A fortified seaport on the northernmost coast 
of France, on the Strait of Dover, forty miles northwest 
of Lille. 

La Roclielle. A fortified seaport, in Charente-Inferi- 
eure on the Atlantic, nearly mid- way between Nantes and 
Bordeaux.. Population: 1907 (estimated), 51,553. 

Havre. A city in the north of France, department of 
Seine-Inferieure (Normandy), on the north side of the 
estuary of the Seine, at its entrance into the English 
Channel, 143 miles northwest of Paris, It is an activei 
manufacturing center. Being the port of Paris, Havre 
does an extensive passenger trafiic and is connected by 
rail and steamships with all parts of the world. Kegular 
lines of steamers pl}^ between Havre and Havana, the 
West Indies and South America.. Population: 1861, 
74,336; 1891, 114,004; 1907 (estimated), 132,430. 

Montpellier. A city in the south of France, celebrated 
for the brightness of its atmosphere and the mild salu- 
brity of its climate. Population : 1891, 69,238. 

Marseilles. The most important port of Southern 
France, department of Bouches-du-Ehone (Provence), at 
the head of a bay which opens into the Gulf of Lyons. It 
is 200 miles southeast of Lyons and 535 miles south of 
Paris. Its commerce extends to all parts of the world, 
and it is the principal point of debarkation of passengers 
for the various ports of the Mediterranean and the East. 
Population: 1862, 260,910; 1881, 269,340; 1891, 403,749; 
1907 (estimated), 517,498. 

Mindin. A suburb of Nantes. 

Montoir-de-Bretagne. Commonly called Montoir. A 
town in Loire-Inferieure, twenty-nine miles northwest of 
Nantes. 



FRANCE — AIX, 1696. 363 

Nantes, Capital of the department of Loire-Inferieure 
(Bretagne), at the confluence of the Erdre and Sevre- 
Nantaise Kivers, and 245 miles by rail west of Paris, 
Next to Brest, it is the most important port on the Atlan- 
tic coast of France. The city is built on several small 
islands in the Loire, which comanunicate with each other 
by means of numerous bridges. A canal connects iNantes 
with Brest. It has many manufactures and an extensive 
maritime commerce. Population: 1886, 127,482; 1891, 
122,750; 1907 (estimated), 133,247. 

Paris\ Capital of France. 

Rochefort. A city on the west coast of France, depart- 
ment of Charente-Inferieure (Saint Onge), on the Char- 
ente Elver, seven miles from its entrance intoi the Bay 
of Biscay. It is twenty miles southeast of La Rochelle, 
and eighty-nine miles southwest of Poitiers, and is an 
important commercial center. Population : 1851, 15,508 ; 
1871, 18,352; 1891, 26,170. 

Saint-Nazaire. A city on the west coast of France, in 
Loire-Inferieure (Bretagne), at the mouth of the Loire, 
thirty-seven miles by rail, west of Nantes. It is the ter- 
minus of passenger steamers which ply between that part 
of France and Mexico and the West Indies. Population : 
1851, 2,400; 1881, 16,314; 1891, 26,467. 

AIX. 

YELLOW FEVER YEAR. 
1696. 

;SUMMARY OF EPIDEMIC. 

The pestilence which ravaged Rochefort in 1694 caused 
the French government to take extraordinary precautions 
against the importation of yellow fever, and to these meas- 
ures inaugurated by Pontchartrain, Aix undoubtedly 
owes her escape from an invasion of the dreaded pest in 
1696. In the month of August, of that year, the squad- 
ron of Admiral de Pointis, which had been cruising in the 



364 HISTORY OF YELLOW FEVER. 

/ 

West Indies, arrived in the harbor of Aix. There were 
many cases of yellow fever on board the vessels, and they 
were ordered to quarantine, for fear that the disease 
might be introduced on shore. These drastic steps were 
instrumental in confining the malady to the ships. ^ 

BORDEAUX. 

YELLOW FEVER YEARS. 
1811, 1881, 1899. 

Summary of Epidemics. 

1811. 

The archives of Bordeaux are silent regarding the pre- 
valence of yellow fever in that town, in 1811, but Robert 
(Guide Sanitaire, vol. 1, page 104), claims that several 
cases were observed in the shipping. According to this 
authority, no casesi erux)ted on shore. 

1875. 

No cases of yellow fever were observed in the city 
proper, in 1875. but the following infected vessels were 
detained at the quarantine station '7 

The Orinoco, from Brazil. Two deaths from yellow 
fever on the passage to 'Bordeaux. 

The Senegal, two deaths. 

The Liguria, one death. 

The Gironde. One death while in the harbor of Bahia, 
Brazil^ and four cases and two deaths on the voyage from 
Bahia., one of the deaths occurring six days before the 
arrival of the vessel at Bordeaux. 

The Gorcovado, from Brazil. This vessel arrived at , 
about the same time as the Gironde, with an unclean bill 

* Berenger-Feraud : Traite Theorique et Pratique de la Fievre 

Jaune (Paris, 1890), p. 37. 
^ Armaingnaud: Memoires et Bulletins de la Societe de 

Medecine et de Chirurgie de Bordeaux, 1875, p. 253. 



FRANCE BORDEAUX, 1881. 365 

of health, and 416 passengers. The authorities, although 
apprehensive of the introduction of yellow fever, found 
it impossible to segregate the passengers, as the lazaretto 
could accommodate only 210 at the utmost. As no cases 
had occurred during the voyage, pressure was brought 
upon the government to release the passengers, with the 
result that they were allowed to go free, but the vessel 
was remanded to quarantine for observation. 

The dumping of over 400 persons from a vessel said to 
be infected with yellow fever upon an immense non-im- 
mune population, caused widespread criticism, both in 
France and abroad, but no diffusion of the disease event- 
uating the incident was soon forgotten. 



1881. 



A severe epidemic of yellow fever ravaged the French 
possession of Senegal in 1881 and the settlers fled to 
their native land. By this means, some of the steamers 
plying between the West Coast of Africa and Europe were 
contaminated and carried the disease to several ports of 
France. 

The Case of the Edga'rd. 

Yellow fever erupted at Saint-Louis, the capital of Sen- 
egal, on July 24th, 1881. The English steamship Edgard, 
with a crew of twenty-one, arrived at the town on August 
1st, and, although the port had been officially declared 
infected, remained at the wharf for twelve days, commu- 
nicating freely with the shore. On August 13th, the ves- 
sel embarked seven refugees and left for France. The 
following day, yellow fever erupted on board, in the per- 
son of a fireman, who died on the ITth. On the 19th, 
another fireman was attacked and died on the 26th. On 
the 21st, an oiler was taken ill and died on the 29th ; on 
the 31st, a cabin-boy was attacked, dying on September 
2nd. On September 1st, the second engineer was stricken. 



366 HISTORY OF YELLOW FEVER. 

Such was the melancholy record when the Edgard 
steamed into the harbor of Bordeaux on September 3rd. 

The passengers and crew were transferred to the laza- 
retto at Paulliac, where fifteen additional cases, with one 
death, occurred, exclusiyely among the sailors. The sec- 
ond engineer also succumbed a few days after his removal 
to the lazaretto. 

The most singular phase of this outbreak on board of 
the Edgard^ is that not a single passenger suffered, the 
attacks being confined exclusiyely to the crew. The 
escape of the passengers from infection is belieyed by 
Duyal^ and Berenger-Feraud^ to have been due to the 
fact that they fled to the poop of the yessel as soon as the 
first case erupted and remained aloof from the nidus of 
infection during the entire yoyage from Senegal to Bor- 
deaux. The oflicers, with one exception, had no commu- 
nication whatever with the sick, leaving them to the care 
of the surgeon, and escaped ; but the unfortunate engineer, 
who communicated freely with the patients, was less for- 
tunate, as we have seen. 

Of the twenty-one composing the crew of the Edgard^ 
six were attacked and five died on the voyage from Saint- 
Louis to Bordeaux, and fifteen were affected and twO' died 
(one an officer) in the lazaretto at Paulliac, making ai 
total of twenty-one cases and seven deaths.^ 



The Case of the Conde. 

The French steamship Conde, plying between Senegal 
and Bordeaux, arrived at Saint-Louis, on August Tth, 
1881. There was no sickness on board. There was un- 
restrained communication between the town and the ves- 
sel. On August 15th, sudden appearance of yellow fever 



« Duval : La Fievre Jaune a Goree, Senegal (Bordeaux, 1883), 
p. 84. 

9Bereng:er— Feraud : Trails Theorique et Pratique de la 
Fievre Jaun^ (Paris, 1890) p. 183. 



FRANCE — BORDEAUX, 1881. 367 

on board, in the person of two sailors and the chief cook. 
)The three patients were sent to the hospital on shore, 
where they died in a few days. Oh the 20th, the captain 
was taken ill and died on the 21st; another case erupted 
the same day. That same afternoon (21st), the vessel 
left for France, having taken thirty-two refugees at Saint- 
Louis. An attempt was made to coal at Dakar, but when 
the condition of the vessel was made known tO' the author- 
ities, permission was denied. After an appeal to the colo- 
nial government, the vessel was allowed toi coal from 
barges in mid-stream, extraordinary precautions being 
taken to prevent contamination. On August 23rd, the 
Concle resumed its voyage. The wisdom of the authori- 
ties of Dakar in prohibiting the vessel from landing at 
her wharves soon made itself manifest. Three days after 
leaving Dakar, the fever broke out again. Following is 
the record of deaths from the 27th to the time of the 
vessers arrival at Bordeaux, September 9th : 

August. September. 

27th 1 1st 1 

29th 2 2nd 2 

30th 2 5th 1 

31st 1 6th 1 

7th 1 



When the Conde arrived at Bordeaux, the passengers 
and crew were sent to the lazaretto at Paulliac, where one 
death took place on the 9th, two on the 10th, and one on 
the 11th. 

The Conde furnished altogether thirty-two deaths from 
August 15th to September 11th, seven at Saint-Louis, 
twelve on the homeward voyage and four at Paulliac. The 
number of cases is not stated by our authority.^^ 



"Duval, loc. cit, p. 85. 



368 HISTORY OF YELLOW FKVKR. 

The Case of the Richelieu. 

A tiiird infected vessel reached Bordeaux, in 1881. 

The Richelieu, one of the largest paissenger steamers 
plying between Bordeaux and Senegal, arrived at Bor- 
deaux, on September 26th, 1881, with 105 refugees on 
board. The vessel had come directly from Bop-Diara, 
Senegal, where yellow fever was prevailing. The captain 
gave the following history:!^ 

The Riclielieii arrived at Goree, Senegal, on August 
3rd, 1881; on the 13th, arrived at Saint-Louis and 
anchored near the camp of Bop-Diarra, where most of the 
yellow fever cases from the capital were sent. On Sep- 
tember 7th, the disease erupted on board, three patients, 
being sent to the hospital. On the 9th, another patient 
was sent to the hospital. On the 9th, 105 refugees, sol- 
diers and civilians were embarked, and the vessel left for 
home. On the 10th, a young girl and a seaman were taken 
ill and sent ashore, the vessel being still in the river. An- 
other case erupted on the evening of the 10th, resulting in 
death on the 12th. The captain, attacked on the 11th, 
recovered. The chief cook, also attacked on the 11th, 
recovered, although he had black vomit. A sergeant was 
taken ill on the 12th, and a soldier on the 13th ; both died 
on the 16th. Another soldier died on the 17th. A sailor 
from the Tamasi, died on the 18th. This was the last 
case. 

When the Richelieu steamed into the harbor of Mar- 
seilles, on September 26th, only eight days had elapsed 
since the last death, and the vessel was detained at Paul- 
liac. No other cases erupting, she was given free pratique, 
and the passengers allowed to proceed on their way after 
being detained only a short while. 

The Case of the Tamesi. 

The steamship Tamesi, on. board of which there had 
been many deaths while the vessel was in the Senegal 

"Duval, loc. cit., p. 86. 



FRANCE BORDEAUX, 1899. 369 

Eiver, near Saint-Louis, arrived at Bordeaux, on Septem- 
ber 15th. She carried no passengers and had had no 
eases on board since leaving Saint-Lonis. The vessel wa^ 
disinfected and given immediate pratique. 

; KeSUME. 

It will thus be seen that, in less than fifteen days, four 
vessels infected with yellow fever entered the harbor of 
Bordeaux, two with cases on board, one with a dismal 
history of the ravages of the disease among its passengers 
aind crew during the homeward voyage, and the other hav- 
ing been decimated while riding at anchor opposite a nidus 
of pestilence. 

1899. 

The French steamship La Plata left Eio de Janeiro, 
October 10th, 1899, for Bordeaux, via Senegal. Among 
the passengers who took passage at Dakar, Senegal, was 
a lady, who fell sick during the voyage. Her case was 
diagnoised as yellow fever. There was no sickness on 
board and no cases of yellow fever had been observed since 
she had left Kio de Janeiro, so it is evident that the in- 
fection came from Dakar. On the ship's arrival at Bor- 
deaux, the patient was sent to the Lazaretto, where she 
died a day or so after.^^ No other cases occurred, either 
on board the La Plata or at Bordeaux. 



Havelburg: U. S. P. H. & M. H. Reports, 1899, vol. 14, p. 2318. 



BREST. 

YELLOW FEVJEK YEAES. 

1802; 1811; 1815; 1839; 1856. 

SUMMARY OF EPIDEMICS. 
1802. 

Yellow fever was brought to Brest, in 1802, bj itha 
French squadron commanded by Admiral Villaret de 
Jojeuse. The fleet was composed of the following yessels : 
Le Toiirville^ rUnion^ VAigle, Le Foudroijant and Le 
Conquer ant, and came directlT from San Domingo. Yel- 
low fever was then committing fearful ravages among the 
European troops in the West Indies. The returning 
soldiers were the remnants of a splendid army, under 
General Leclerc, consisting of 1,500 officers, 20,000 
soldiers and 9,000 seamen, which had been sent by the 
French government to occupy San Domingo,' restored to 
France by the famous ''Peace of Amiens," which treaty 
set at rest the quarrels between England, France, Spain 
and Holland concerning their West Indian possessions. 

The squadron, which had been infected at San Domingo, 
arrived in the roads at Brest in the autumn, of 1802. 
There were forty-two men sick with yellow fever oh the 
different vessels. These were transferred to the lazaretto 
at Treberon. 

A customhouse employe, who had been sent, to guard 
the Trouville, on which the majority of the cases had 
occurred, contracted the disease and died at his home 
on shore within forty-eight hours. Two other inhabitants 
of Brest were infected and died on the fifth day of their 
illness. These three cases, erupting in the very heart of 
the city, caused intense consternation, and the authorities 
took immediate steps topreven t any communication what- 
ever between the vessels, the lazaret and the shore. These 

"Cornilliac: La Fievre Jaune dans les Antilles, 1886, p 403. 



FRANCE BRJEST. 371 

strict sanitary measures, proved effective, for no. other 
cases occurred. 

Out of the forty- two cases sent, to the lazaretto at Tre- 
beron, twenty-three, died. 

I8I1! 

According to Eobert ( Guide Sanitaire, vol 1, p. 104 ) , a 
few cases of yellow fever were observed in. the shipping 
at Brest, in 1811. No cases occurred on shore. 

1815. 

Yellow fever prevailed in the harbor of Brest, in 1815, 
(Cornilliac, RechercJies CJironologiques^ etc., 1886, page 
228). Only a few cases are recorded. 



1839. 



Yellow fever was brought to Brest, in 1839, by the trans- 
port La Caravaney from Martinique. ^^ There were 116 
cases, out of a crew of 142, on the homeward voyage, and 
the convalescents were transferred to the lazaret at Brest. 
Only one case (a convict) erupted at Brest, The total num- 
ber of deaths among the crew of La Garavane amounted 
to thirty- three. 

According to Berenger-Feraud,^^, the Garavane had been 
contaminated at Fort Eoyal, Martinique, where she had 
taken some soldiers on board. One of these soldiers was 
taken sick with yellow fever and died. From that moment, 
the vessel became infected. 

1856. 

The cruiser La Fortune brought yellow fever^to Brest, 
in 1856. 

On May 8th, 1856, La Fortune left Brest for an ex- 

^* Cornilliac: La Fievre Jaune Dans les Antilles, 1886, p. 414, 
^^ Berenger-Feraud, loc. cit, p. 511. 



372 HISTORY OF YELLOW FEVER. 

tended cruise. ^^ After touching at Goree, Senegal, the 
vessel crossed the Atlantic and arrived at the lies du 
Salut, French Guiana, on July 7th. On July 10th, sixty- 
three passengers were embarked at Cayenne, where yellow 
fever was raging epidemically. One of these passengers 
was taken ill wth the fever on the 13th, but was imme- 
diately transferred to the hospital on the island. La 
Fortune sailed on July 15th, for Martinique. A second 
passenger, taken sick on the 22nd, was landed at Fort- 
de-France on the 26th. Six passengers were embarked 
at the latter place, and on the 29th, the cruiser reached 
Basse-Terre, Gaudeloupe, where yellow fever was prevail- 
ing, rrhirteen passengers were taken on board at Basse- 
Terre. On the 30th, the vessel set sail for Brest. On 
August 1st, the third case of yellow fever erupted on 
board, followed in quick succession by other cases, the 
last case occurring on September 7th, three days after the 
vessel had arrived at Brest. 

Out of a crew of 212, there resulted 118 cases, with 
56 ^deaths. Of the fourteen inhabi taints of Brest, who had 
business relations with the vessels, three were attacked 
and two died.^^ 

DUNKIRK. 

1881. 

A vessel from Senegal brought yellow fever to Dunkirk, 
in 1881. The cases were sent to the quarantine station. 
There was no diffusion of the disease. (Berenger-Feraud, 
p. 184). 



^« Cornilliac. La Fievre Jaune Dans les Antilles, 1886, p. 419, 
"Gerardin and Reau: Rapport sur des cas de Fievre Jaune im- 
portees a Brest en 1856 par la Corvette de Charge La 
Fortune, venant des Antilles. Bulletin de TAcademie de 
Medicine de Paris, 1856-7, vol. 22, p. 899. 



HAVRE. 

YELLOW FEVER YEAES. . 
1861; 1881; 1900. ; 

SUMMARY OF EPIDEMICS. 

1861. 

The ship Harriet brought yellow fever to Havre, in 
1861. Immediate steps were taken to isolate the vessel as 
soon as her condition becaone known to the authorities, 
who sent her to the Island 0)f Tatihon, in the English 
Channel. Nn new cases erupted, the disease being con- 
fined to the original focus. {Berenger-Feraud, p. 138). 

Melier^^ gives a more elaborate account of the incident. 
He states that the Harriet was quarantined at Havre, in 
1861, on account of yellow fever. On page 187, in an 
extract from a report by Dr. Launay, assistant health 
officer of Havre, it appears that while at sea the captain 
of the Harriet was attacked by yellow fever on June 15th, 
1861, died June 18th, and wais buried at sea June 19th. 
The second case occurred on July 5th, 1861, died July 8th, 
and was also buried at sea. Two more Avere observed July 
6th, 1861, one on July 7th, one on July 18th, and one 
on July 19th. All recovered. Total : seven cases ; two 
deaths; five recoveries. 

No statement where the infection was brought aboard 
is made ; no mention of port from which the ship had 
sailed for Havre. Concerning the length of time in quar- 
aintine, the report states that Launay boarded the ship 
and ordered a fumigation and remained on board for five 
days without incurring any unpleasant symptoms. None 
of the men who had been brouglit aboard to help disinfect 
the ship contracted the disease. In fact it seems that the 
cases taken down with yellow fever on July 18th and 19th, 

"Melier: La Fievre Jaune a Saint-Nazaire (Reprint, 1863), 
pp. 73 and 187. 



374- HISTORY OF YELLOW FEVER. 

were recovering or almost recovered when the ship reached 
Havre, and no further cases occurred. 

In 1862, this same vessel was quarantined for three days 
. at Marseilles, merely on suspicion. 

According to Eager,^^ yellow fever was brought by ships 
to many French ports in 1861, but a search through the 
files of the Surgeon General's Office, fails to throw any 
light on the subject. 

1881. 

Yellow fever was brought to the quarantine station at 
Havre, in 1881, by vessels. There was no diffusion of the 
disease.^^ 

1900. 

The French steamship Beam, which it will be remem- 
bered, brought ^YQ cases of yellow fever to Marseilles, in 
1891, entered the harbor of Havre on August 14th, 1900. 
The vessel had come from Senegal, where yellow fever 
was prevailing. She carried fourteen passengers. An 
officer of the vessel had died from the disease on the home- 
ward voyage. The passengers ' were disembarked at th^ 
lazarettO', but no cases erupting, they were released after 
a few days.^1 

pn August 9th, 1900, the French steamer Caravallos, 
with about 300 soldiers from Senegal, arrived at Havre 
with a case of yellow fever on board. The patient was 
then in his ninth day and convalescent. He was sent to 
the lazaretto. On July 31st, two passengers had died 
from yellow fever on board, and the case mentioned above 
had erupted August 1st. The vessel was remanded to 
quarantine. ^^ 



"Eager: Bull. No. 8, Yellow Fever Institute, Washington, D. 

C, 1902, p. 29. 
-" Berenger-Feraud, loc. cit., p. 184. 
^^U. S. P. H. & M. H. Reports, 1900, vol. 15, p. 2235. 
''Mbid, pp. 2121; 2173. 



FRANCE. 375 

A third ship infected with yellow fever arrived at Havre 
from Senegal, in 1900. On August lOh, the Santa Fe en- 
tered the port with several cases of yellow fever on board, 
having had two deaths on the homeward voyage. The 
vessel was sent to the quarantine station. The sick re- 
covered and no other cases erupted. ^^ 

In none of the above instances was the disease diffused 
ashore. 

LA rochelle; 

In a history of the city of La Eochelle, published by 
Arcere, in 1756, there is a reference to an importation of 
yellow fever into that town in 1700.^^ We have been un- 
able to find any authentic corroboration of this report. 

MARSEILLES. 

YELLOW FEVER YEARS. 

1802; 1804; 1807; 1811; 1820; 1821; 1823; 1870; 1891; 
1899. 

Summary of Epidemics. 

1802. 

Yellow fever prevailed on several ships at the lazaretto 
at Marseilles, in 1802, but the case of the Columbia is the 
only one of any epidemiological interest. 

The Columbia took a cargo of sugar and tobacco at 
Havana in the beginning of 1802, and left that port for 
Providence, Rhode Island, where she arrived in May. 

D. C), 1902, p. 25. 
^^Ibid, p. 2173. 
^* Eager: Yellow Fever Institute Bulletin No. 8 (Washington, 



S76 HISTORY OF ^-ELLOW FE\-ER. 

She discliarged a portion of her cai^go at Providence, and 
took on an entii^ely new crew. The vessel left the Amer- 
ican port on May 24th. and after tonching at Malaga. 
Spain, entered the harbor of Marseilles, on August 9th. 
The vessel was subjected to ten days* quarantine. On 
the T^ei^y day of its release, the captain was taken ill and 
died on the sixth day of the onset of the malady. The 
day after the captain's death, a sailor was taken ill. 
While a consultation of doctors was in progress, to de- 
termine what this fatal disease could be, a third member 
of the crew was attacked. The vessel was immediately 
ordered again to quarantine. Ten days having elapsed 
without any new case, the ship was again released. ^o 
sooner was this done, than a sailor was taken ill and died 
on the sixth day of the onset. For the third time, the 
vessel was sent to quarantine, where three other members 
of the crew successively died from yellow fever. 

There were altogether eight attacks. followe<i by as 
many death. The fir-st case erupted on August 28tli, fol- 
lowed bv death on September 3rd, the last ease, October 
10th. 

The disease did not spread to the shore, according to 
Chervin,^^ 3Ioreau de Jonnes,-^ Robert-^ and Berenger- 
Feraud,^ from whose works this summary is taken. The 
source of infection in this instance was undoubtedly 
Havana. It is true that yellow fever was also prevailing 
at Malaga, where the Cohimhia touched on her voyage 
from Providence to Marseilles, but the fact that the fever 
only erupted at Marseilles after the ship had b^un dis- 
charging a cargo consisting among other things of 1,000 

"CherTin: ZxaiLezi .ir- Piil-Iiits ie rAdministration en 

Maiiere Sanitaire (Paris), 1S27, p. 38. 
"Moreau de Jonnes: Notice sor les Enqnetes Officieles Con- 

statant la Conta^on de la Fievre Janne et de la Peste 

(1825), p. 4. 
"Robert: Guide Sanitaire des (Joavememen Europeens (Paris, 

1826), voL 2, pp. 470; 708. 
^Berenger-Feraud: Traite Theorique et Clinique de la Fievre 

Jaime (Paris, 1890), p. 72. 



FRANCE MARSEILLES, 1804. 377 

barrels of sugar from Haivana, is strong enough evidence 
to incriminate tJie Cuban port. Mosquitoes are proverb- 
ially fond of sugar, and a few of these infected insects 
were undoubtedly taken on board at Havana, where yel- 
low fever was epidemically present at the time of loading. 
As the ship sailed further north, the mosquitoes secreted 
themselves in the remotest corners of the hold, where the 
cold could not penetrate, remaining hidden while the ves- 
sel was at Providence, and only reappeared at Marseilles 
when the unloading of the sugar was begun. It was lucky 
for the inhabitants of Marseilles, that the first cases 
empted on board, and that the summer was almost over, 
for had the Columbia arrived a month previously, the in- 
fected mosquitoes would probably have inoculated her 
large non-immune population and contaminated the town. 

1804. 

Marseilles had another narrow escape from yellow fever 
invasion in 1804. 

The Damish brig Le Gidllaume, from an English port, 
touched at Malaga in August, 1804, where she was con- 
taminated and lost one of her crew while at that port, 
August 25th. She left for Marseilles in September, and 
lost two more of her crew on the voyage. She arrived at 
the French port, on October 8th, and was ordered to pro- 
ceed to quarantine. While at the lazaret, a midshipman 
was attacked on October 13th. Tavo of the health-guards 
contracted the disease, one on October 15tli, the other on 
the 25th. All these cases proved fatal. Total number of 
cases, eight; one at Malaga, two at sea and three at the 
lazaret. 

The following infected ships were also brought yellow 
fever to Marseilles, in 1804 : 

The Danish ship Limpte, from Malaga. One case at 
Lazaret. 

An unnamed Danish ship from Malaga: One death, 
October 15th, at lazaret. 



37 8 HISTORY OF YELLOW FEVER. 

The Danish ship Bonheur cle la Famille, from Malaga. 
Arrived at Marseilles October 22nd. Two deaths from 
yellow fever on voyage from Malaga. fThe captain was 
attacked on the day of the ship's arrival and died at the 
lazaret on the 31st. 

The Swedish brigantine Amitie arrived at Marseilles, on 
November 13th, after having touched at Seville, Malaga 
and Alicante, all infected ports. Several deaths while at 
sea. Four of the crew were ill with yellow fever when 
the shij) reached the lazaret, two dying on the 16th. The 
captain died on I^ovember 20th. Three other cases erupted, 
there resulting altogether eight deaths, four of which were 
from the vessel and four emitting at the lazaret.-^ 

In none of the above instances was the disease com- 
municated to the shore. 

1807. 

(On August 20th, 1807, the American schooner Fame, 
from Boston, with a crew of six, arrived at Marseilles. 
The captain claimed that he had not touched at any port- 
on his way from Boston, but the vessel was nevertheless 
sent to quarantine, and only released on September 3rd. 
Eight days afterwards, the captain was taken sick and 
, died on shore with all the symj^toms of yellow fever. Xo 
other case erupted. ^^ 

1811. 

The sporadic cases of yellow fever observed at Mar- 
seilles, in 1811, were evidently imported from Spain, as 
the maritime annals of that port are silent concerning the 
prevalence of the disease on ships coming from the An- 
tilles. The vomit o negro was epidemic in Cadiz, Cartha- 
gena, Alicante and other populous -cities of Spain that 
year, and was no doubt brought to Marseilles by refugees 

^'Robert: Guide Sanitaire, vol. 2, pp. '472; 719. Also: Berenger- 

Feraud, loc. cit, p. 79. 
"'' Berenger-Feraud, loc. cit., p. 82. 



FRANCE MARSEILLES, 1811. 379 

from the Spanish Court, who sought safety in flight from 
the intrigues of the plotters against the throne of the un- 
fortunate weakling, Charles IV, who during his entire 
shameful reign, was under the influence of his wife and 
her paramour, Godoy. 

The weather conditions in Marseilles, in 1811,) were 
abnormal. The summer months Avere excessively hot, 
wheat and leguminous plants withering before attaining 
maturity, the torrid rays of the sun parching the earth 
and drying up springs and streams. Fulminating apo- 
plexies, bilious disorders and even cholera-morbus were 
almost epidemic, and fevers generally assumed a grave 
or fatal type.^^ Under such conditions, it is not surpris- 
ing that yellow fever, once introduced, obtained a tem- 
porary foothold in the. town, and the only reason why it 
did not attain eiDidemiological proportions, is no doubt 
due to the absence of the Stegomyia Calopus from the 
localities where the cases mentioned by Kobert were ob- 
served. Had these carriers of infection been present, Mar- 
seilles would no doubt have experienced a pestilence which 
would have been appalling in its results. 

We have been unable to find any complete statistics 
concerning this outbreak. Eobert mentions that he at- 
tended many cases, eleven of which proved fatal.^^ 
Among his patients were de Villena, the faithful field- 
marshall and grand chamberlain of Charles IV, who died 
with black vomit a week after being attaicked. Another 
victim was Father Fernandes, also an attache of the 
Spanish Court. Eobert, who is an authority on yellow 
fever, says he cannot be mistaken as to the nature of the 
disease. He was in attendance daily at the bedside of 
the two Spaniards, having been requested by their vSov- 
ereign to give them the best medical 'care and minutely 
describes every phase of the malady which carried them 
off. The illustrious French physician also gives a clini- 
cal history of nin^e other cases in his practice which ter- 



^^ Robert, loc. cit., vol. 1, p. 104. 
^^ Robert, loc. cit., vol. 1, p. 104. 



380 HISTORY OF YELLOW FEVER. 

minated fatally, making in all eleven eases. There prob- 
ably were other manifestations of the disease, as Kobert 
only reports the cases which came nnder his personal 
observation, but we were unable to find any authentic 
evidence bearing on the subject. The first case reported 
by Eobert, that of de Villena, erupted on Sunday, August 
4th, 1811, and died on August llth.^^ The last case was 
attacked on September 26th, and died on October 15th.^^ 
The fact that the malady first manifested itself in refu- 
gees from Spain, where yellow fever was almost general, 
strenghtens the theory that it was imported from that 
country. Kobert, like most observers of his day, attri- 
butes the eruptions to abnormal weather conditions, a 
dogma which seemed rational then, but Which modern 
medical science has relegated tO' oblivion. 

1820. 

In the month of July, 1820, two soldiers who formed 
part of a sanitary cordon on the sea-shore in the neigh- 
borhood of Martigues, a town in the department of 
Bouches-du-Khone, France, twenty-one miles southwest of 
Aix, were transported to the hospital at Marseilles, where 
they died two days afterwards with the characteristic 
symptoms of yellow fever. There was no diffusion of thcJ 
disease.^^ 

1821. 

The yellow fever epidemic which prevailed in the quar- 
antine slip of the Island of Pomegue, in the harbor of 
Marseilles, in the fall of 1821, is interesting from a point 
of transmission and proves the danger of mooring infected 
vessels in the immediate vicinity of uncontaminated ones. 
That the wind blew infected mosquitoes from one vessel 
to another, the history of the progress of the epidemic 

3^ Robert, loc. cit, vol. 1, p. 113. 
^* Robert, loc. cit., vol. 1, p. 125. 
^ Robert, loc. cit., vol. 1, p. 142. 



>SIT10NS OF THE VESSKLS IN THE QUARANTINE SLIP AT 
MARSEILLES DURING THE EPIDEMIC OF 1821. 



^^ST. 



^ovr^ 



Case. 




deaths 



FRANCE MARSEILLES, 1821. 381 

plainly shows. It was impossible for the ships in the 
quarantine basin to communicate with each other, as 
health-guards were stationed on every one of them, and 
the distance between each vessel was too great to admitj 
of communication without having recourse to boats. As 
all boats had been ordered by the authorities to be hoisted 
high above the water, only craft conveying provisions and 
the sick or dead being allowed to communicate with the 
island, no other mode of infection than the mosquito- 
laden wind can be incriminated. 

The facts of this memorable epidemic, as related by 
Eobert,^^ Eager,^'^ Berengert-Feraud^^ and, Melier,^^ are 
as follows: 

Yellow fever was committing fearful ravages in Spain, 
in 1821, and it was natural that the disease should make 
its appearance sooner or later at one of the ports of 
France. Anticipating this, the authorities ordered that 
the strictest quarantine be observed, a precaution which 
evidently proved the salvation of Marseilles, as subsequent 
events demonstrated. 

jOn September 7th, 1821, the Danish brig Nicolino^ Cap- 
tain Mold arrived at the lazaretto of Marseilles (on the 
Island of Pomegue), with a history of yellow fever on 
board. The vessel had come direct from Malaga, an in- 
fected port, where it had remained from July 3rd to 
August 26th. 

On September 1st, while en route to Marseilles, a sailor 
named Jenwersen, aged 20, was taken ill, but was con- 
valescent when the JSficolino entered quarantine. On Sep- 
tember 2nd, four days' journey from Marseilles, a>nother 
sailor, Stobuy, aged 23, was taken ill. The poor fellow 
was abandoned by his companions and died on Septem- 
ber 3rd. His corpse was thrown into the sea, together 
with all his clothes, bedding, etc. 

'' Robert, loc. cit, vol. 1, p. 622. 

^^ Eager: Yellow Fever Institute Bulletin No. 8 (Wasliington, 

D. C), 1902, p. 26. 
^Berenger-Feraud, p. 98. 
^^Melier: Fievre Jaune a Saint-Nazaire en 1861, 



382 KI8TORV OF YELLOW FEVER. 

On September 8tb tlie hatches of the Xicolino were 
opened. The imprisoned mosqnitoes undonbtedly began 
spreading the infection from that date, as subsequent 
events will demonstrate. 

On September llth, four days after the XicoUno's 
arrival, a third sailor was taken ill. He was sent to the 
lazaretto on the 13th, and died the following dav. 

At this time, there were forty-one vessels, practically 
from all parts of the world, in the quarantine slip. The 
position of each vessel will be better understood by re- 
ferring to the plan which accompanies this account, taken 
from the works of Eobert and Metier. As the illus- 
triotis French nosologists do not always mention the name 
of the vessel, but in most instances gives only that of 
the captain, we have inserted the latter where the former 
was not obtainable. 

The vessels infected were as follows : 

I. The Xicolino, the original focus of infection. 

II. The Comte-de-Goes. Captain Chiozotto, arrived 
•from Saint-Jean-d'Acre and Cyprus, August 29th. Moored 

next to the Xicolino, On September 8th, while taking 
the breeze on the bridge of his vessel. Captain Chizotto 
was incommoded by the foul odors emenating from the 
hold of the Xicolino. Knowing that the vessel was in- 
fected, he was greatly alarmed and fled to his cabin, ex- 
claiming ^'Somo morto!''^^ He was stricken with yellow 
fever on the 13th, and died on the 15th. The infection 
spread to the balance of the crew, composed of twenty-one 
persons, resulting in ten cases and five deaths, including 
the captain. 

III. The f^ainf-Georfies, Captain Demorre. Arrived 
at PomegTie September 3rd, from Aigles, Spain. Moored 
to the northwest of the Xicolino, from which it was sepa- 
rated by the Stevens. Two sailors taken ill September 
14th, died the follo^-ing day. There were altogether 
eight cases and four deaths. 

** "I am a dead man I " 



FRANCE MARSEILLES 1821. 383 

TV. The Catherine^ Captain Simon. Left Malaga, 
August 19th, and arriYed at Marseilles, September 3rd. 
Was placed in the quarantine basin, to the northwest of 
the Nicolino. A sailor was taken ill September 14th, and 
died on the 21st. Four additional cases erupted, followed 
by recovery. 

V. Captain Bexfield's ship, from Xante, arrived on 
September 7th, and anchored next to the Nicolino^ on 
the northwest. A cabin-boy and a sailor were taken ill 
September 11th, and the captain on the 11th. All re- 
covered. 

VI. Floating Dock, about fifty metres to the S. S. E., 
of the NicoUno. A man who was working on this dock 
was taken ill September 20th. He was discharged cured 
from the lazaretto October 18th. 

VII. Captain Matiovich's vessel, from Alexandria, 
Egyi>t. Arrived September 9th. Moored to the north- 
west of the Nocolino^ from which it was separated by six 
vessels. A sailor was taken ill on September 22nd. He 
recovered. 

IX. Captain Vinello's ship. Moored to the southeast 
01 the NicoUno, from which it was separated by the Gomte- 
de-Goes . Two cases erupted on board, followed by death. 

Seven other vessels were contaminated, making sixteen 
in all, out of a total of forty-two which were lying at 
anchor in the quarantine basin, including the NicoUno. 
All the vessels w^here cases occurred were lying to the 
windward of the NicoUno. This encouraged the general 
belief of the period, that yellow fever was carried by the 
wind. "Eobert and others brought this prominently into 
view, giving as incontrovertible proof of the correctness 
of this dogma,, that the '^foul ordors"'^! from the hold of 
the NicoUno were carried by the wind to the vessels which 
afterward became infected. Of course, we of this enlight- 
ened age know that the wind merely accelerated the emi- 
gration of the Stegomyia calopiis, but the illustrious med- 
ical men of the period did not have twentieth century 



*^ "Les odeurs infectes." 



384 HISTORY OF YELLOW FiLVER. 

Spectacles, and could only formulate myopic theories. 

A few cases were also observed on shore.^^ 

On September 23rd, a case erupted in the heairt of Mar- 
seilles. This was a health officer, who having been em- 
ployed in cleaning the quarantine quarters:, was sent to 
the lazaretto when yellow fever appeared in the shipping. 
He was released after ten days' detention, and returned 
to his lodgings in town. He was shortly afterward at- 
tacked with yellow fever. He was immediately sent back 
to the lazaretto, together with all the inmates of the 
house where he was stopping. The man died, but none 
of his companions contracted the disease. 

Another case erupted in a hospital at Marseilles, in the 
person of a sailor who had come by land from Barcelona, 
Spain. He was sent to the lazaretto. 

A Danish ship, commanded by Captain Fohn, left Mal- 
aga, Spain, September 20th, and arrived at Marseilles, 
October 1st. The captain was ill and three of the crew 
had died from yellow fever on the voyage from Malaga. 
Fearing to again kindle the fires of contagion, the author- 
ities positively prohibited the vessel from landing and 
forced her to take to sea again. The doomed vessel was 
buffeted by the waves, and finally struck a reef near the 
shore, foundered and was burned to the water's edge. 
The captain, with the remnant of his crew, were sent to 
the lazaret at Pomegue. One of the sailors developed 
yellow fever, on October 10th. The patient recovered."^^ 

The government thought it was face to face with an in- 
vasion of yellow fever, and communicated with the cele- 
brated Professor Palloni, who had been through the yel- 
low fever epidemic of 1804, at Leghorn, and whose advice 
was no doubt largely instrumental in preventing the 
spread of the disease. 

The first case occurred September 7th ; the first death, 
September 14th. Last case, October 10th; last death, 
October 6th. 

^^ London Medical and Physical Journal, 1821, vol. 46, p. 463. 
^^Berenger: Feraud, loc. cit., p. 99. 



FRANCE — MARSEILLES, 1893 385 

Cases and deaths: At lazaretto, 25 cases 5 12 deajths. 
At Marseilles, 2 cases ; 1 death. Total, 27 cases, 13 deaths. 

1823. 

An American ship. Captain Thomas, left New Orleans 
for Marseilles, on September 21st, 1822, and arrived at 
her destination, November 19th. During the voyage, two 
deaths occurred from some '^unexplained cause,'' accord- 
ing to the statement of the captain. As yellow fever was 
prevailing at New Orleans, when the vessel sailed, these 
two deaths were undoubtedly due to the disease. On ar- 
riving at Marseilles, the vessel was sent to the quarantine 
station, at Pomegue. On November 29th, a sailor was 
taken ill and sent to the lazaretto, as his case appeared 
suspicious. He recovered in a few days without showing 
any of the symptoms of yellow fever, and was sent back 
to his ship on December 10th. Nothing untoward hap- 
I)ened until January 24th, 1823, when this same sailor 
was suddenly taken ill and died at the lazaretto in thirty- 
six hours. The autopsy revealed unmistakable lesions of 
yellow fever.^^ ' 

This case greatly puzzled the learned medical men of 
the period. They knew nothing of the mosquito doctrine, 
and wrote innumerable monographs on what they termed 
one of the most extraordinary and longest incubations of 
yellow fever on record. They dated the sailor's illness 
from his first indisposition, November 29th, and looked 
upon his fatal illness in January, as the culmination of 
the infection contracted on the previous date. 

At the present age, the incident is easily explained. 
The fact is, that the first attack was not yellow fever, 
but simply some gastric disturbance accompanied by feb- 
rile manifestations. On his return to the ship, the man's 
duties undoubtedly required him to be often in the hold, 
where he was evidently bitten by infected mosquitoes 
taken on board at New Orleans. 



** Robert: Guide Sanitaire des Gouvernemens Europeens- 
(Paris, 1826), vol. 2 p. 745. 



S86 HISTORY OF YELLOW FEVIR, 

Kobert^^ gires the clinical history of a case presenting 
mast of the STniptoms of yellow fever, which he treated 
at Marseilles in 1823. The patient, a woman aged 62, 
was taken ill July 16th, and died JuIt 31si. 

1S62. 

For nearly half a century (1823 to 1862) we find no 
mention of yellow fever having been observed either at 
the quai-antine station at Marseilles or on vessels arriv- 
ing from infected ports. 

During the year 1862, fifty-nine vessels carrying sixty- 
nine passengers and a crew of 792, arrived at Marseilles 
from Havana, Matanzas, Pernambuco, Sainte-Croix-de- 
Teneriffe, and other infected ports. Only vessels coming 
from Havana were contaminated, the following giving 
histories of yellow fever on board during the voyage i^^ 

UEtoile, 14 cases, 4 deaths. 

TiUe de Cannes. 10 cases. 3 deaths. 

Montvenion. 13 cases, 5 deaths. 

CedarSj 4 cases, no deaths. 

Curra. 2 cases, no deaths. 

In none of these instances did any cases erupt while 
the vessels were undergoing quarantine, nor was there any 
diffusion of the disease on shore. 

1870. 

In 1870, yellow fever was epidemic in several cities of 
Spain (q. v.), and the sea coast towns of France observed 
a strict quarantine against the infected localities. 

On September 8th. ISTn. the Spanish vessel Carpio 
arrived in the harbor of ]\Iarseilles, having come directly 
from Barcelona, where yellow fever was prevailing. A 
quarantine of seven days was imposed on the vessel. Xo 
cases developing on board, she was given free pratique. 

** Robert: loc. cit., vol. 2, p. 140. 

**Blache: In Melier's Fievre Jaune a Saint-Nazaire (Reprint), 

p. 204. 



FRANCE MARSEILLES. 



The wisdom of precautionary measures soon made itself 
manifest. On September 26th the Greek ship Argos en- 
tered the harbor of Marseilles with yellow fever on board. 
Out of a crew of eleven men, there had been four deaths 
from that disease — three while the vessel was at Barce- 
lona, and one while at sea, September 23rd, three days 
before her arrival at Marseilles. Extraordinary precau- 
tions were taken to prevent contamination. The vessel 
was completely unloaded and sent to the Riou,^"^ where 
she was thoroughly disinfected. 

A Greek, one of the crew of the Penayaj died at the 
Hotel-Dieu, the municipal hospital of Marseilles, on Sep- 
tember 29th. The autopsy revealed characteristic lesions 
of yellow fever. This man had come by land to Mar- 
seilles. His compatriots on board the Argos^ denied that 
he had communicated with them, but the statement was 
disbelieved by the authorities, as there was no pestilential 
disease on board the Panayaj and the inference was drawn 
that the sailors of the two ships had probably mingled 
either at sea or at some port on the Spanish coast, where 
the Greek contracted the infection.^^ 

No other cases developed at Marseilles in 1870. 



1891. 



On May 17th, 1891, the French ship Beam, from Rio 
de la Plata, South America, arrived at Marseilles with 
yellow fever on board. The vessel carried 665 passengers. 
There had been several cases and ^^e: deaths during the 
homeward voyage. On arrival at Marseilles, five cases 
were sent to the lazarettoi The passengers were isolated 
for ten days, after which time, no new cases developing, 
they were given free pratique. Of the five cases sent to 
the lazaretto, four recovered.^^ 

*^An islet seven miles south of Marseilles. 
*«Roux: Marseille Medical, 1871, vol. 8, p. 193. 
*'' Skinner: Bull. No. 7, Yellow Fever Institute (Washington, 
D. C), 1902, p. 2. 



388 HISTORY OF YELLOW FEVER. 



1899. 



The French ship Aquitaine, from Buenos Ayres, entered 
the harbor of Marseilles, on XoTember 3rd, 1899. There 
had been a case of yellow fever on board, followed by 
death. Another case erupted shortly before the vessel 
reached Marseilles, and was sent to the lazaretto on her 
arrival. The passengers were released after three days' 
detention. The patient recovered.^^. 



MINDIN. 

YELLOW FEVER YEAR. 

1881. 

Summary of Importation. 



The steamship TilJe de Paris, infected at Martinique, 
brought yellow fever to Mindin, a suburb of Xantes, in 
1S81. The vessel left Martinique, May 20th, with a crew 
of 128 and forty-five passengers. Among the latter were 
four convalescents from yellow fever. On June 2nd, thir- 
teen days after leaving the island, the first case occurred 
on board, followed by others on the 3rd and 4th. The 
vessel arrived at Mindin on June 5th. The patients were 
transferred to the lazaretto at Mindin, where out of five 
cases, four proved fatal. The disease was confined to the 
lazaretto. {Bercnger-Fevaud, loc. cif., p. 183). 



"'Skinner: Bulletin Xo. 7. Yellow Fever Institute (Washing- 
ton, D. C), 1902, p. 2. 



MONTOIR-DE-BRETAGNE. 

YELLOW FEVER YEAR. 
1861. 

Summary of Epidemic. 

Many of the longshoremen employ-ed in discharging the 
cargo of the Amie-Marie during the Saint-Nazaire out- 
break of 1861, lived at Montoir-de-Bretagne, a village 
twenty-nine miles west of Nantes. Four members of this 
gang being taken ill, knocked off work and went home. 
They were attended by the village physician, Dr. Chaillon, 
who also was attacked by yellow fever on August 13th, 
and died on the ITth. The other cases recovered.^^ 

J 

MONTPELLIER. 



1821. 



YELLOW FEVER YEAR. 
Summary of Importation. 



A single instance of the appearance of yellow fever at 
Montpellier is on record. Deveze^^ and Robert^^ assert 
that eleven soldiers were treated in the hospital of that 
town by Broussonet, in 1821. The patients had contracted 
the disease in the little town of Rose, a seaport of Catalo- 
nia, Spain. The infection did not spread. Our authori- 
ties do not say w^hether the cases died or recovered. 



" Berenger-Feraud, loc. cit., p. 137; Melier, Fievre Jaune a 

Saint-Nazaire. 
•^Deveze: Memoire au Roi (Paris, 1821), p. 14. 
"Robert: Guide Sanitaire, vol. 1, p. 104. 



NANTES. 

YELLOW FEVER YEAES. 
1857; 1899. 

SUMMAEY OF IMPORTATIONS. 

1857. 

Yellow fever was quite prevaleiit on ships in the harbor 
of Nantes, in 1857. The number of cases is not stated, 
but the deaths are said to have amounted to seven. ^^ 

1899. 

In October, 1899, there were two cases of yellow fever 
on board the steamship Navarre, from Vera Cruz, in the 
harbor of Nantes. The cases proved fatal. The vessel 
^as sent to the Saint-Nazaire lazaretto. No other cases 
erupted. {V. S. Public Health Reports, 1899, vol. 11, p. 
2000. 

PARIS. 

1775. 

, Yellow fever has never been observed in Paris, but on 
three occasions^ — 1775, 1822 and 1845 — a disease mani- 
festing almost identical symptoms set the medical world 
agog. 

The earliest mention of a disease resembling yellow 
fever being seen in Parish will be found in the works of 
Portal,^^ the celebrated French Physician, who flourished 
in the reign of Louis XVI. Portal mentions several cases 
which came under his observation, some even attended 

"Skinner: Bulletin No. 7, Yellow Fever Institute (Washing- 
ton, D. C), 1902, p. 1. 

"Portal: Observations sur la Nature et le Traitement de 
Melena, p. 174. 



FRANCE PARIS. S91 

I 

with black vomit, in which most of the symptoms which 
characterize yellow fever were present. He particularly 
describes a case in which a large quantity of black matter 
was vomited, the description of which corresponds with 
that of the true vomit of yellow fever. One of the indi- 
viduals mentioned by Portal was no less a personage than 
the Comte de Vergennes, Minister of Foreign Affairs, 
under Louis XVI, who it will be remembered adopted the 
deliberate policy of humbling England by promoting the 
independence of the United States by the alliance of 1778. 

1822. 

Robert^^ and La Roche^"^ relate that in the summer of 
1822, after a long continuance of unusually hot weather, 
there occurred in the Hotel Dieu, of Paris, several cases 
of fever accompanied with jaundice and black vomit. Two 
patients were, at the same time, similarly affected at La 
Charite, in the wards of Dr. Lerminier, and several in- 
stances of what was denominated sporadic yellow fever 
were seen in Paris. In reference to the patients admitted 
in that hospital, AndraP^ informs us that they had deli- 
rium, a black tongue, tympanitic bowels, a jaundiced dis- 
coloration of the surface and exhibited evident signs of 
an ataxo-adynamic state of the system. They both threw 
up a quantity of a substance bearing a strong resemblance 
to soot — an appearance which, as we shall see, is often 
assumed by black vomit. La Roche doubts, however, that 
those cases were anything more than typhoid fever modi- 
fied by the extreme heat of the season. One of the patients 
recovered under the use of the most powerful stimuli. 
The other died, and the autopsy revealed a gastro-enter- 
itis, with red softening of the mucous membrane, and 
ulceration of the intestines, an anatomical character which 
our authority states does not belong to yellow fever. 



"Robert: Guide Sanitaire, vol. 1, p. 104. 

"La Roche, loc. cit, p. 272. 

"Andral: Dictionaire de Medecine, 1st ed., vol. 21, p. 17. 



392 HISTORY OF YELLOW FEVER. 

Magendie^^ mentions, that at about the same period, 
eleven cases of fever occurred in the hospitals of Paris, 
attended with brown yellow color of the skin, petechiae 
and black vomit. 

Lassis^^ claims that there were more patients ill with 
what is commonly termed yellow fever in the hospitals of 
Paris in the month of April, 1822, than at Barcelona and 
Port du Passage at the time these two ports were causing 
the medical world such anxiety. 

Chervin,^! who is anything but an admirer of Dr. Lassis, 
pokes fun at the Englishman for believing that these cases 
were manisfestations of yellow fever, and criticises him 
for predicting that Paris may eventually become like Mos- 
cow, Barcelona;, Marseilles, Aries, Aix and Toulon, the 
active seat of pestilential disasters, whose magnitude 
would be unparallelled in the annals of epidemiology. 

We believe that the stand taken by the eminent La 
Eoche the most correct for, unless imported, yellow fever 
cannot under the most favorable conditions of weather 
and temperature, originate in Paris. And, even if the 
disease were accidentally introduced there, it would not 
spread beyond the imported cases. 

1845. 

The Gazette des Hopitaux for August, 1845, contains 
the account of a case of typhus which occurred in the 
wards of Dr. Rayer, at the Hopital de Charite, Paris, 
which presented most of the symptoms peculiar to yellow 
fever. It may also be compared to the cases observed by 
Portal, in 1775, and by Andral and others, in 1822, men- 
tioned in this volume. 



"Magendie: Lecons sur les Phenomenes Physiques de la Vie, 

vol. 1, p. 117. 
»° Lassis: Calamites Resultant du Systeme de la Contagion 

et Meme Celui de L'lnrection (Paris, 182 — ), p. 19. 
"Chervin: Examen des N'ouvelles Opinions de M. le Docteur 

Lassis (Paris, 1823), p. 3. 



FRANCE — -PARIS, 1845. 393 

On the 30th of June, 1845, a man named Thomas, of 
strong constitution entered Dr. Kayer's male ward. He 
had been ill for a few days only. The following were 
the symptoms presented: Yellow-orange tinge of the en- 
tire body ; skin dry and hot ; the eyes and inferior surface 
of the tongue, yellow; the superior surface of the tongue 
covered with a mucous fur; nausea; slight tympanits of 
the abdomen, painful on pressure, in the right hypochon- 
drium ; liver of normal size, on percussion ; stools colored 
by bile, not abundant; urine deeply tinged with bile; no 
abnormal thoracic symptom, but acute pain felt in the 
hepatic region on deep inspiration. Pulse full, frequent, 
but regular. The patient only complained of pain in 
the right hypochondrium, and of intense cephalagia. 
Venesection to twelve ounces. Blood presented a thick 
buff. 

July 1st. — Same state. Cupped on the hepatic region ; 
blister on the same region. Saline purgative. 

July 2nd. — Vomiting set in ; the matters vomited were 
black and sanguinolent. The stools, liquid and abundant, 
contained black and feces tinged with bile. Pulse very 
frequent ; cephalagia; somnolence; tongue dry and 
cracked; teeth presented a brownish crust at bases; abdo- 
men meteorized not painful on pressure. 

This state persisted on the 3rd and 4th. On the 4th, 
slight delirium appeared. No spots or ecchymosis on the 
skin, universally of an orange-yellow. On the 6th, the 
state of the patient seemed improved. A number of small 
conial elevations appeared on every part of the body, 
similar to those of variola in its first stage. On the 7th, 
these elevations had formed red ecchymotic spots, like 
those of haemorrhagic roseola. There was, however, no 
symptoms of roseola. 'The patient appeared, indeed, bet- 
ter, although still in a state of semi-somnolence. On the 
8th, the somnolence had increased; an eschar appeared on 
the sacrum; the stools were still sanguinolent. On the 
11th, the eruption disappeared; somnolence and general 
depression increased; nausea, but no vomiting. On the 



394« HISTORY OF YELLOW FEYER. 

12tli, he remained in a state of comatose sleep, and died 
suddenly on the 13th. 

Autopsy, twenty-eight hours after death : The body was 
in a state of advanced putrif action, the epidermis separat- 
ing with the greate.st case; icteric tinge of the skin, the 
same as during life ; no effusion of blood in the intermus- 
cular spaces ; lungs healthy, but containing a considerable 
quantity of mucus and blood; heart, soft, containing 
black blood; mucous membrane of the stomach softened, 
of the color of dregs of wine; duodeum presented traces 
of sanguineous suffusion, and contained yellow bile; the 
rest of the intestines contained mucous, colored with bile ; 
Peyer's glands were not enlarged; no morbid alteration 
in the large intestine; the liver presented the usual vol- 
ume, being soft, of an uniform icteric tinge; the vena 
porta, vena cava and its principal divisions were healthy, 
and contained black fluid blood; the biliary vesicle con- 
tained a considerable quantity of blood; the spleen was 
soft, of normal volume; the kidneys, soft, yellow, nearly 
diffluent ; the brain, soft, and presenting the icteric tinge.^^ 

1883. 

According to Berenger-Feraud, a case of yellow fever 
was observed in Paris, in 1883, in the person of a diplo- 
mat, "who had handled dispatches coming from an in- 
fected country." Beyond giving his source of information 
as "les journaux politiques," our authority is mum. We 
have made a strenuous search through the French period- 
icals for the year 1883 and 1884, on file in the Library 
of the Surgeon-General's Office, at Washington, but find 
no mention of the incident. 

TTve Parisian Mosquitoes and Yellaw Fever. 

It is within the range of possibility that the mosquitoes 
of Paris could convey the yellow fever virus. The alarm- 



* Lancet (London), 1845, vol. 2, p. 231. 



FRANCE PARIS. 395 

ing increase of mosquitoes in the capital of France was 
the theme for animated and interesting discussions by the 
medical societies of the metropolis a few years ago. At 
the session of the Academie de Medicine de Paris, April 
9-13, 1901, Dr, Debove called the attention of his con- 
freres to the fact that, in certain districts of Paris, mos- 
quitoes were so numerous as to incommode the inhabi- 
tants to a great extent, and intimated that summary meas- 
ures should be instituted to mitigate the nuisance. ^^ 

J)r. Laveran observed that mosquitoes w^re certainly 
more numerous in Paris than formerly, and ascribed this 
fact to the vast number of places where stagnant water 
was allowed to^ remain. The learned scientist argued 
that it should be an easy task to educate the people to 
adopt measures to destroy the pests. If the population 
were instructed that the smallest amount of stagnant 
water is sufficient to engender enough mosquitoes to in- 
fect an entire district, they would be more careful. The 
Pasteur Institute had been appealed to by many indus- 
trial establishments of Paris to devise means to destroy 
mosquitoes, and had given advice which had already been 
attended by beneficial results. 

Dr. Laveran further observed that the mosquitoes of 
Paris were of the culex variety, which are positively 
known to transmit filaria and malaria. The former dis- 
ease was very rare in Paris, but the latter was quite com- 
mon, and its prevalence could no doubt be traced to the 
insects under discussion.^^ 

Dr. Farabeuf, in concluding the discussion, related his 
experience at Bourg-la-Eeine^^ and and L'Hay, near Paris, 
where the mosquitoes were undoubtedly responsible for 
the many febrile disturbances which made life anything 
but agreeable at these places. Measures should be taken 



"Bulletin Medical (Paris), 1901, vol. 15, p. 319. 
"Ibid, 508. 

" Bourg-la-Reine is a town on the Seine, five miles southwest 
of Paris. 



396 HISTORY OF YELLOW FEYER. 

at once to exterminate these insects, or the localities in 
question would in the near future become uninhabitable.^^ 

The qtiestion was also taken up by the Societe de Biol- 
ogie de Paris, at its session held June 1st, 1901. The 
trend of the discussion was the best mode of protection 
against the stings of mosqtiitoes. It was generally ad- 
mitted by the speakers that most of the methods popularly 
used, stich as essences and oils, were practically of no 
raJue, affording only temporary immunity, as the mos- 
quitoes finally got used to the odor and became as aggres- 
sive as ever.^' 

Dr. Laveran said that the only stire mode of immtmity 
-^'as to protect the hands by gloves, and to wear a veil, so 
as to protect the face and neck. This was the plan in 
vogue by most of the railroad employes in the malarial dis- 
tricts of Italy. Perfumed oils was no protection against 
the stings of the insects. ^^ 

Dr. Laveran's idea is certainly the most efficacious, but 
we doubt very much that the dandies of Paris wotild take 
kindly to the fashion of wearing veils. 

Dr. de Gouvea, a Brazilian scientist who had taken 
refuge in Paris after the revoltition of 1893, sotmded an 
additional note of warning in an exhaustive article en- 
titled Les ILousflques et la Fievre Jaune, in which, among 
other things, he cited the historic epidemic of Saint- 
Xazaire to prove the facility with which yellow fever can 
be transmitted by mosqtiitoes.^^ 

ROCHEFORT. 

1694. 

Was it vellow fever which devastated Rochefort in 
1691? 

•* Bulletin Medical, loc. cit., ^ 341. 
*' Bulletin Medical, loc. cit.. p. SOS. 
" A statement which can be vouched for by the writer, who 

has tried the experiment in New Orleans. 
•'De Gouvea: Bulletin Medical, 1901, xq\. 15, p. S61. 



FRANCE ROCHEFORT, 1694". 39? 

La Eoche'^^ claims that there can be no doubt on that 
score, and cites Chirac in support of this contention. 
Many authors, among whom are such eminent authorities 
as Pringie/^ Boissdau,'^^ Berenger-Feraud'^^ and Kerau- 
dren"^^ hold the view that the epidemic under discussion 
was either typhoid or the plague, an opinion we are in- 
clined to share, after a careful perusal of the writings of 
the illustrious Chirac. 

Yellow fever may have been brought to Kochefort in 
1694 and occasioned some mortality, but what is com- 
monly understood as the '^great epidemic" of that year 
was undoubtedly the bubonic plague of the Orient, prob- 
ably brought by ships from the eastern ports of the 
Mediterranean. 

Chirac, "^^ who was sent by Louis XIV to study and re- 
port upon the malady which was then devastating Roche- 
fort, had exceptional facilities for observation, and pub- 
lished the result of his researches in two volumes. The 
work, which is printed in the quaint old French style of 
the period, goes into the minutest details, and is an ad- 
mirable exposition of the peculiar views of medicine in 
general held by the learned medicos who flourished in the 
reign of the Grand Monarch. 

We note from Chirac's observations that most of the 
diseases which prevailed at Rochefort in 1694 assumed 



^"La Roche: Yellow Fever. Considered in its Historical, 
Pathological, Etiological and Therapeutical Relations 
(Phila., 1855), vol. 1, p. 48. 

"Pringle: Observations on Diseases of the Army (London, 
1800), p. 323. 

"Boisseau: Physiological Pyretology; cr, A Treatise on 
revers (Phila., 1832), p. 333. 

^^Berenger-Feraud: Loc. cit., p. 35. 
''*Keraudren: Projet de Reglement, etc. 



S98 HISOORY OF YELLOW FEVER. 

a grave character. An epidemic of small-pox was fol- 
lowed by one of measles, and when the latter had sub- 
sided, fevers of a malignant and dealy type asserted them- 
selves. These fevers were eventually absorbed in June by 
the pestilential malady under discussion, which carried 
away two-thirds of those who were attacked.'^^ It was 
especially mortal in July and August and began to sub- 
side by the end of the latter month, after a series of heavy 
rains had filled the swamps about Rochefort and seemed 
to purify the air, which during the dry season, "smelled 
like burning gunpowder."''"^ 

The symptomatology of the disease, Vhich is minutely 
and graphically described by Chirac, leaves no doubt as to 
its nature. The malady was ushered either by a chill or 
by an intensely cold sensation, with acute headache and 
a sensation of extreme heaviness. The pulse became small, 
there was a general feeling of faintness, attended by an 
incessant agitation of the limbs. The fades became lead- 
en-hued and cadaveric. In some instances, the eyes were 
dull ; in others, sparkling and restless. Nausea and vom- 
iting were constantly present, many never regaining their 
natural warmth, but being as cold as marble when death 
put an end to their sufferings. Cold sweats and a com- 
plete coma generally preceded death. (Page 53). 

In the the majority of cases, the parotid glands were 
affected and buboes appeared in the axillary regions, 
but were rarely seen in the inguinal regions. Those in 
which buboes appeared on the fourth, fifth or sixth day, 
generally succombed; in cases where the buboes only ap- 
peared on the seventh, eisfhth or ninth day, recovery gen- 
erally ensued. In some cases, carbuncles broke out on the 
face and hands, a symptom which was generally followed 



^* "Cette maladie, qui fit perir les deaux tiers de ceaux qui 
etoient attaques, ne relacha and ne finit que par des 
grandes pluyes qui arriverent a la fin du moi d'Aout, et qui 
remirent de I'eau dans les mares et dans tous les marais 
deffeches de la prairie." — Chirac, vol. 1, p. 57. 

77 «* * * une odeur de poudre brulee." — Chirac, vol. 1, p. 31. 



FRANCE ROCHEFORT, It 94. 399 

by death. The stools were either serous, greenish, dark, 
viscous or sanguinolant, and very often dysenteric. Hem- 
orrhages from the nose were frequent. The urine was 
natural up to the fourth day of the onset, after which it 
became either red or very dark until the end of the attack. 
When poured in a vessel, it left a reddish residue, which 
resembled brick-dust. (Page 55). 

Such is the description given by Chirac. We have made 
as literal a translation of the original text as possible. 
It does not require a Board of Experts to arrive at the 
deduction that the malady in question was not yellow 
fever. The symptoms, though not exactly those of the 
bubonic plague, are so nearly identical, as to easily lead 
to the conclusion that the pestilence of Rochefort was 
simply a milder manifestation of that terrible disease. 

How such an astute observer like La Roche should have 
been led into error by the description of Chirac, is beyond 
our comprehension. La Roche's work is a classic and a 
monument to the author's genius and versability and this 
faux-pas merely goes to show that even the greatest minds 
are not infallible. 

Whether it was the bubonic plague, yellow fever or 
typhoid which devastated Rochefort, in 1694, there is no 
doubt that the French government was taking extraor- 
dinary precautions that year to prevent the importation 
of the Antillean pestilence to its shores. A search into 
the musty records of that period reveals the fact that the 
maritime archives of Rochefort contain a letter from the 
Minister of Marine (the renowned Pontchartrain), dated 
September 15th, 1694, in which this dignitary states that 
he has been informed that the disease (yellow fever) was 
still raging in the "American Isles," and that it was im- 
portant that steps should be taken to prevent its introduc- 
tion into the kingdom. He also states that he had written 
to the admiralty official of La Rochelle to renew the meas- 
ures which had formerly been taken against the crews of 



400 HISTORY OF YELLOW FEVER. 

vessels coming from these countries and to observe strict 
quarantine against infected vessels.'^ 

The narrow escape of Aix (q. v.j from infection, iu 
1696, proves that these precautionary measures were nut 
taken a moment too soon. 

SAINT-NAZAIRE. 

Yellow Fevee Years. 

1861 ; 1862 ; 1881 ; 1899 ; 190S. 

Summary of Epidemics. 

1861. 

The outbreak of yellow fever which took place at Saint- 
Xazaire, near Xantes, in 1861, occupies a notable place in 
the annals of epidemiology, being the only serious mani- 
festations of the disease in France. Accidental eruptions 
have occurred from time to time in the heart of Havre, 
Brest, Marseilles. Eochefort and Xantes. but these were 
directly traceable to persons who had communicated witJi 
infected ships and were limited to one or two cases. In 
the Saint-Xazaire incident, however, the disease assumed 
a vicious and aggressive type, and was even carried to 
Montoir-en-Bretagne, a village near Saint-Xazaire. 

"The original letters reads as follows: 
"15 Septembre, 1694. — ^J'apprends par les lettres que je recois 
par le vaisseau le Leger, que la maladie continue 
toujours aux isles de TAmerique; cela est bien facheux. 
Cependant. comme il est important d'empecher qu'elle 
ne s'introduise dans le royaume, j'ecris aux officiers de 
TAmiraute de la Rochelle de renouveler les defenses 
qui ont ete faites aux equipages des vaisseaux, qui 
reviennet de ces pays, de ne mettre pied a terre qu'apres 
que la visite en aura ete faite, pour les obliger de faire 
quarantaine, s'ils sont att-aques de ce mal et c'est a quoi 
il est necessaire que vous teniez la main. 

(Signed) "PONTCHARTRAIX." 



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"orj diqsia^a^g aq) jo .waja aq; jp ami^nBain aq; u\ 

•jaAa^ AioxxaA jo paip pi3q aq ^Bq:^ :^aFj ^i\\ pa^eaAaj 
qoTq.\i ^saTpoq aq:^ jo ano jaAO ppq s^Ai. i^sdojoan b 'asaq-^ jo 
eajq; jo q^Fap aq:). Ja^V 'JaAaj arpni^d mojj Snija^ns sb 
Xi3:^idsoq \b?>o\ aq:^ o; pa:^:^impE aja.^ Avajo aq; jo sjaqraani 
][Ej:aAas 'douDd^ ^d/j eq^j jo jt^atjju aq:^ ^^U^ s.^i3p A^aj y 

•snoT^oajTp :^aaja^[p ni §nTja:^;Bas sjaStrass^d 
QT[% 'papn^i siaSuassBd aq; hm pni? ^\iajD aq; pni? ^anbi^^jd 
paAiaoaj ^ajrezB]^ 'ig ;b x^^I^^it^ nodn ^diqsraFa^s aqj[j 

•SuTXTi^Aajd sE^\i jaAaj a\ioiia.)L ajaq.^ ' (oi '^dag) anbint; 
-j-Hn ^aaui}jj-ap-;joj ;b paqano; SniA^q Ja;ji? ^8061 91 ^^^q 
-ina;dag ^lod :).uq; ;b paAijjB qaTq.ii^2)C>if?xf^ »^ dnxsin^ais 
qauaij aq; Aq ajTuzB^ •;g o; ;qSnojq suiii asBasip aqx 

: (IS9T -efSI '1021 '^f^ '2Z lo^ '8061 
^s^dmld^i 1Ul'D^E ^IW^d 'S 'fl) ^^-^o\\oi su ajB s;dujj aqj, 
*ajii?zB^-;nTi?g jo ;jod aq; o; suoT;i^;jodraT jaAaj AvonaA 
JO ai^qa aqc^ ni i[m\ ;s^x aq; saqsrajnj 8061 ^^^^ ^^X 

'8061 

•pa;dnja sas^a jaq;o o^ -noi; 
-b;s aui;uBJBnb aq; o; papnuuiaj su^is. jassaA aqx gg'P*^^^^ 
no jaAaj A^oxja^ ^^V'^ ajTi3zux:--^niBg %m paAijJu ^^iuq 
•BJaA xnojj ^9MwaD\r diqs qanajj aq; ^6681 ^Jaqo;ao nj 

•6681 

lit '8061 — aHivzvN xNivs — aoNVHj 



'08^ ■<J 'I "P^ '(8881 '"BAauao) eiqd^JSoniea ap ;a 

Xu;t(Ibd piTOjd jeq puB P^Itmnj i^oaqdojd s^pjBqoo^ jossaj 
-ojj 99S puH e^[B.vii? i!Bp atto I'uui eom^jj 'eq sSniq:^ qons 

JO aiquduo ^siidoiOQ mfhuofJo:}.^ aqqi n^q:^ jaq:^o snneS aq:^ 
JO o^Tubsoin JO pnpi uiu;j80 b :^Bq:^ iiionq 9xii op .iioq pniy 
•aji^ei SI siq; :^nq 'eieSiio{ s9ini:^aiiios tsA^i^p naAas o:^ oas.:\. 
mojj ST j9Aaj .^oipA JO poTjad aAi^T^qnoni paqsitqu^sa aqx 

I 'Si^Up U8A9S JO 

noT^nai^ep v o:\. papaCqns ajuo aii? '^eiod ni paijjb s;t uo 
pjuoq no i^n^^-^^^ ^I J^Aaj ^vion^-^ naqAs. naAa ^sdiqs pa^oajni 
mojj sjaSnassd ^Bq:^ (x9 QiOT^jy) aoi^on aAV /aiiSuA ni .iiocc 
s.viBi ani^ni^JEiib aq:^ Suipi^ai no ^joj ';nainnjaAO£) qonaj^ 
aq:^ Xq papaaq aij:^ naaq aAuq sSnrajn.^i asaq:). ^ng 

t8u'siTi3xVV s:^T oTqi^T.ii passKiii spios 
noTiIini 0.^; aq; Snomu asiieo ppioAV :^i aoA^q aiqijja:^ ^Eq.ii 
^p^iduD aq; ipBdi pip asuasrp aq:^ ^i?q; Sni:^:^TuipB ^naq; pny 
^uiuj| ^xan aq:^ Xq sijuj o| paij.iuD Sniaq inojj as^asip 
aq; :^naAajd p[iio:i^ i^uqAS. ^paqooi-iaAO aja.\i sajtisi^am £j.^:\. 
-lUBS ^OTj;s :^i3q:^ pnu ^ajrezi? !S[-:^nii3g :^i3 aAieiJi? p{noqs jaAaj 
Avoip-'^ ^^^^ papajni x^ssaA m %isi\^ asoddns sii ^^a^ -sijuj 
:^B AtqF^ou pnT? ^aDuujj jo ^j)39q aqj ni asna:^ni si ;uaq aq:^ 
naqi^ ^^snSny pni? Ajiif ni s^Cnp nrei^jao ajB ajaqx 'Ap^P 
--emj^u uoT^sanb aq; jaA\.snu o:^ ssaupyoq anpnu aq ppio.vi 
^I ^^M^ 9Ci SAu.\iiH :^i np^ ^^^a -noipajni jo snooj x^^ 
-LoTJO aq:^ pnoXaq pBajds jaAon s^q ^i ^sajoqs Jiio o; pa;jod 
-mi naaq si^q jaAaj Aioxjal naq.\i ^^^Bp siq:). o; ^pni? jps:^! 
sa^i^Sndojd Ans^a asuasip aq; ajaqAV saij^nnoo ni?q; j^aj 
o; ssai ST?q ^apn^i^i^ JaqSiq s;i jo ;nnoooi3 no ^aon^jj,, 

: s:^Ji?maJ ;na.onnd ;som siq jo noi^Bisnuj; i? si Snmojio^ 
•jaSm3p aAT^.iS siq; q[no pa;niod ^ssajppu pajidsni ub nt 
^pjT^qoo^ 'JQ •sainsBain aAi;naAajd jo ^nBinaojojna aq; ni 
XEx oo; Sniaq joj pajusnao sai;iJoq;ni3 aq; pnB ;no pa;nTod 
iCiqiojoj ST?AV aoni3J^ o;ni iuviut) sniidfi^ aq; jo noi;Dnpoj; 
-ni aq; jo jaSn^p aq; ^pa;Bdpi:^Ji3d (xni^apjog jo) ;ai!Bq; 

•a5iAaj AVoiiaA ao ahoxsih Olt 



£12 ■<! 'II 
10^ '8881 'suBd 'aonBJ^ sp anbnqnd: anaiS^aP JFWIPs 
-noo e^nnoo np xncABJi sop n^i^^^^H i^Bnaa np voj|Uf)„ 

pnB (piJpBK JO) oipqBQ ^(sfiJBa: jo) pjBqDoa; '{noqsii 
jo) opBHTY ^^TIS ^P *(:^iopiiDoa: jo) iLumoe; '(snue^jQ 
MB^ jo) o:^ueinjoj sjd qoiq^ ni ^uoTssnosip xBJdnajg is uj 

eqa JO Jouuaani aq:^ %^ pa^Fi^ip^B irre^u seji nousenb ht^j^ 

-:^oa^ B HBq:^ poijed JoSnox ^ JOj iii-?i>'as siq irr jjiibZ eq:^ 
peT.jJi?o suosjad esaqi jo ano naAa puq ph:lv-[t) dAuq aqj3Tui 

-naaap s.:^aa^ t? axuo Ja^B JLjaaoj a^i3|Tiajp oi dTi{> ]>ai,:,hjiii 
^tsuoTJo:^on i? mojj suosiad ^oUiAiOipi- ; ' - '~-p 1 1^::: ^^x 

•qiOo ^^^ no atruuijijBnb uIl'.:^ p--y-;Hj j^^^^ha 
aq:^ pnn ^asi?o :^SBt aq:^ jo noT|diLja aq| jaiy^B SAi?p iq.^iH a^ho 
/q:^gX ^^K ^o anbi^Bjd aajj naAiS aja-ii sj^f-^s- _ ;I nqj^ 

■pajaAooaj ano Apio ajaq.^^ '^T-s~'^ -- :'-iaii^zE| 
eqi o:^ ^nas ajaAi ^jaqnmn ni dAit •-::i-:_':jl: -ui pny rr'JU 
-13:^8 anii^HBJBnb aq:^ o| :^iias sba^ x^>^^^ ^'^i- "X-^ -^^-•K ^0 

*];XT na:^F^ shai aaAas jo piiqo u "a-gp einus iBqx 
-q:^f aq:^ no ajiBZB^^uTBg %^ paAijjB pssaA aqx I'^iIil la 
sasi?.3 aajqj ^Anp jxan aqx 'UdpjDDjY aqi t[i:ai T^_o:a 
• noo snosjad q:^iAv s^mxFap An-eni puq pi^q l^.a q^-v^i 
aq:^ o:^ paqoi?:^^ jaaniSna ub sbai asBa syqx '^"'r'^'^-'d'^P 
-91U± aq:^ no :^iio a:50jq jaAaj AicqpA •9?Tr'j.ij[-dp-:i'j j mojj 
aJiUJBdap jaq ja^i? SA^p n-^-:::^- pu;: ^-rp nf) 

•jaAaj Aion^A Tnojj sin^: --^ cau :o jil ji ,^:iT^q jeia^x 
aqi SnoniB ^sja^nassBd cf puc n[:i j- a^jo c ^ila 'qiOo 
ABj^ no ^aou^.ij-ap-;joj^ ajax jamBni^ -^qj^ p-::^jiir u>[b 
sB-ii qoiqji *'w.^?»>//>z>/p ■^Boq-q'ai^-isTp eqi qipA a{9?ij p9a"Ba 
'innninioa ^'j-^J^d-^p-^lUA -'^^ 'Joqiuq aqa m eyiq vi "HAio; 
aq:j ui SnixiBAajd sbai joaaj Aicqpj^ SAUp iiaaijp: paniBni 
-aJ aqs ajaq^w 'qac abji^ ^o 'anbTHiiJUjv •eontuj-ap-iioj 

;b x>^-^I'I'I^ puB 'xs'ST '^^08 ii'i'^Y "^o "nz'^'ia '<;'ipa-'^i'i^(i 

r^jaX ^^j^Dj-dp-diiij^ jaui'Ba:^s Ja^nassud ouiriipFsniui aqx 

ca jaAaj .-iiona-i jo noiiFuodmi pnooas eqa jo sidbj aqx 
60* ■ I S8 [ — 2¥ivzvK J.KIVS — aaxvHJ 



ST ^uoTSBOOO siq:^ no nAio:^ oq:^ epBAUi ^on pip asBasTp aq:^ 
:^Bqx *T88I ^I 'Ap q^naJ J Pio ^ni^nb aq:^ jo sjoop qti% '\is 
uiB^B JOAOj Aiotp^ a^s eAv joj ^eouapnjd jo snapi Xj^nipjo 
-Bj:^xa XuB q:^iAV ejTBZB^-:^niBg jo s9T^TJoq:^nB eq:^ panqrai 
8ABq o:^ maas ^ou saop ^XOSI JO OTraaptda aiqBJoraani aqx 

•T88T 

•ejT'BZBx;4nreg :^B sbai xassaA aq^ ^{TqAS. pa:^dnja sas-eo 
on pm3 ^XEATJJB no i£q:^][Baq ajaA\. Aiajo aqx 'aSi^ifoA pj^^w. 
-amoq aq:^ Suijnp ^^as :^b ano pu^ ^BnBA^H ^^ pj^oq no sasBa 
aAta.\i:^ naaq pnq ajaqx 'I jaqmaoaQ ^o joqjBq aq:). paja:^na 
^jaAaj ALonai! jo £joq.sTq e q:^m yassaA ^sb][ pn^ q:^j^ aqj, 

•snoi:^B:^sajTnBni jaq:^o o^ -ajn^j^d 
-ap JO ^jod aq'} :}b sasBO oai:} jo i!jo(}siq b aA^S ^gx jaqniaA 
-o^ %nBAEH niojj paATjjB qaiqAi ^/luvj^ pur) psuj-iy aqj^ 

•ajTBZB^-:}nTBg ^^ jo ^as ^b sas^o o^ 
•^jod n^quQ aq^ nt anqAi sq^^ap jnoj p^q SnjABq pa:}Jodaj 
^9 jaqnia:}dag ^Bn^ABH ^OJJ paAieiJB qaiqAi 'lodoiOjW^ aqj^ 

•aJoqsB asBasip aq:} jo noisn^ip on sbai 9Jaqx 'pajaAOD 
-aj i^n^i^^^^^^ ^^^^ ajaqAi ^Ddy^(j-9nur>0f p^idsoq Sni^Bog: 
eq} o:} pajjajsnuj:} ajaAi sasBO jnoj ^pAijjB s^diqs aq^ nQ 
•(8X ^l^£) "Bas ^B q^Bap ano £q paAionoj ^BnBABH ^^ SBAi 
[assaA aq; anqAV ^naa^qSia jo Aiajo b jo ;no sasBO naAap 
naaq pBq ajaqx 'c^Jod aq:} o:} jaAaj A^onai! :}qSnojq i!{XBn}OB 
'ox ^snSny "aJtBZB^-^^niBg paqoBaj qoiqA^. ^^dqiy aqx 
•iCq^XBaq ajaA\. Aiaja pnB sjaa^o aq} pnB joiib® aq} jo q}Bap 
aq:^ aanis pasdB}a pBq q^noni b nBq:^ ajoni ^noT:}BnT:}sap 
jaq ;b paATjjB vmnz9g.uoj\[ aq; naqAi pnB ^pJBoq no nosjad 
jaqao i!nB o} pa}BaTnnninioa c^on SBAi jaAaj aqx •asBasip 
aq:} pa;aBJ}noD aq ajaqAi 'ajoqs aq} pa^isiA i^xsnoT^T^dajJUS 
pBq nBni stqx *znjo BjaA ^^ sba^ dtqsjBA^ aq} anqAi jaAaj 
A\.oip^ mojj Aiajo aq; jo ano jo q}Bap aq} pa}Jodaj japnBm 
-moa aq; ;nq 'pjBoq no asBasip snoi;aajnT on sbai ajaqx 
*IX annp ^znjQ 'BJa^ niojj: ^vmnzog^uoj^ jasmjo qanaj^j 
oq; SBAi joqjBq aq; ja}na o^ pssaA snoprdsns ;sjp: aqx 

'X Jaqraaoao; pnB xi annjp 
naaAi;aq ;.jod ^Bq; paqoBaj asBasip aq; q;m pa;DajnT spssaA 

•HIAHJ AVOnSA AO A¥OXSIH 80* 



'661 "^ '898X 'sij^j a'T98I ^^ 8iiBZBN-;niBS ;b 

■^981 

iJBd jaq-;o i!iii3 o:^ paijji^o ^on sb.Vl joabj ajiBzi^^sr^nreg aq; 
^ ( -A 'b ) eaSu^a jg-ap- Jio^no j^ :^e ag^a ib;bj u ino jj apisy 

SS 8^ ^^'\^^^v pnB sasBD ib;ox 

si[:^'B8P £ZTii Snninsaj 'sesBO o^ eiJ-BiM-euny eq; Xq papojni 

sq:^'B9P z ^I Sni|ins9J 'sasBO gx pjBseo-SHioqDisj: eti; -tq papejuj 

sq:^Bap pnn sasBO jo jaqmnn ib;o^ eqx "I9SI ^I ojitJZT^x 
-:^nT]3g JO ^^jod aq:^ pa^aajni 'pjDZ9Q-sDioi[oijii aq:^ pni? 
9iavj^-9uuy aq:^ ^spssaA o.\i; ;]?q; naas aq snq; {ji.\i :^i ■ 

•i?as ;i3 JO sja^u.w 
ni5qn3 ut jaq^ia ^pji^oq no jaAaj .\ionaA jo Ajoi^siq on 3X^2 
,pnB A!q:^[uaq aja.*A SBuapjFQ pni? si^znu^-ej^ inojj spssaA 
8qj, -aiiBzi^X'^^i^S ^^ o:[;aji?zi^{ aq:^ o:^ sasua ;nas ^puvzoQ 
-svioipisi aq; pni? 9UDj\^-9uuy aq:^ ^o.ii:^ pni5 ^pjuoq no 
jaAaj Aiojiai! jo saiJo:|.siq aAU§ aA^ ^^nuAUH ttJOjj sjijaijjb 
9Axa.\i; aq:^ jo •si?napji?3 mojj ano pnu ^si?zni3;i?j\[ mojj 
o.vi; ^i?nuAi,H niojj aja.\i aAja-w; ^spssaA naa;j^ asaq:^ jq 

•Aq;iuaH 
•g ^snSny ^»i?napji?3 :^Te^ -s.oinojg; 'n jaqnia^dag 

•ajojaq sji^aA o.\i:^ jaAaj ^^voip^ 
pi?q pBq oq.\i ^num ano jo nor^daaxa aq:^ q;T.^ ^^ots pjuoq 
no nosjad AjaAg -^as ;i? oav:^ ^BnuAi^jj :^i3 sq;T?ap aajqx 
•0 ^snSny 'bubab^^ i^jaq; '9puo.ii{) -gx Jaqnia:^dag 

i •sq:^Bap on f T?nBAi^H :^b sasi^a xig 

'XS ^inp ^unBABH ^Pl 'siv:i.ur)]si s^uvlu[^ 'f jaqnia;dag 

•c^ ^Pf 'sBznis^BX^ ^jaq '9mi974^ 'f jaqnia;dag' 

^Ot I 98 I 3HIVZVN XNIVS aONVHJ 



•QX A^r 'Bni?AT?xi.^J^T[ 'iwduBwiiQ dJ9j -gx ^sni>ny 

•B8S :^B q:^B9p 
9^0 'SI A'^^^r ^BUEABH :^pt: 'vipiay -gx ^snSny 

•Bas :^B (oe ^i^r) q^^9p 9«o 

•^X ^pr ^^n^A^H ^J9T[ 'disnOny piD^ -gx ^sn^jny 

•g jaqraa^dag paip 
i Qz ^snSiiy ^asuo pjnn y 'P^lP ^^c> i xbaijjis no sasi^o o.^ j^ 
•9X i^ltif 'Bni3Ai?H :^jeT[ 'i?.wz9Q-si)ioipij^i -gx ^snSny 
•i^qi^lBOH '8 ^I^r 'iJtEi^AUH U^T. 'sopif 'g ^snSny 

•9 y^xiif ^i3iruAi?]g; ^jaq; 'U9j\[ vi dp 9iioi[^ 'i :^sni5ny 

•ajTBZHjS[ 
-:^niBg JO OTinapida aq:^ paii^iiigijo aanaq.^i noipajni jo 
snao^ -agi^i^oA pjB.\iaraoi[ no si[:^iiap o.s^\ pue sasBa auiu 
P^H '81 Q^nf ^n^Ai^H ^l^l '9uvj\[-9uuy -gx ^V^£ 

: SnTyiEAajd s t?.A jaAajf AvoxpA a laqAi 
s;jod mojj paATJ.re spssaA Sni.^onoj aq:^ ^XX *iaqnia:^dag 
o; (9id7)j^-9iiuy aq:^ jo x^aijju aq^ jo a^up aq^) gx ^l^r 
raojj ^Bq:|. :^ai3j aq; s^BaAaj ^:^jod aq; jo ^i^snu^ auiprj^ra 
oq; o; aonajajaj y 'XOSX ^I ^aJTFzu^^J4^THg jo joqj^q aq:^ 
paja:^na qaiq.\i jax^aj xiione^ q^T-^ papajni pssaA i^^no aq:^ 
^ou SBi^ 9idDj\[-Duuy aq:^ ^Bq; ai^ou o; STiT:^saja:^ut si :^i 

-g.uw^ Jo uoquvjg; 9i[^ p9Jdg.n[^ ipuim spssDj^ pd^Odfuj 

'O oXI P^^ o8'XI JO Brainini aq:^ pus ''O 
oS'SS P^^ oTZ JO BuiTXBTn aq:). naa.vix^q pa^^^xipso oiniapTda 
aq:^ Snijnp ajn:^i?jadina:^ ^\ivp aqx 'aonan^ni £u^ aA^q o^ 
jBaddB ^on pip ajii^BjadTna:^ SnijreAajd aqx 'as^asip aq'^ 
JO s:^Bajq:^no SninTUijapp ni aonanpuj pappap p^q aA^q 

•HSAad AVo^^^A jo ahoxsih 90t 



o:^ pamaas xassoA papa jut eq:^ JBati passed arai:^ jo q:^Sua| 
aq:^ pu^ a^BJoqauB jo aauB:^STp aq^ 'JaAaj Aionai! uiojj 
aunraniT ^f^i^aajjad aja^i 'pupii aq| an :^Tiq 'didDj^-duuy aq:^ 
jBau pai^sod ^g 'o^^ sw^ndiuorj aq:^ ^:^jodsiiBj:^ jaSnassBd b 
puB 'uobvuj^d'pu'Diiu aq:^ ^aabu tBijaduiT aq:^ jo diqs b :^Bq:^ 
aion o; Siii^saja:^nT si 'w '^^naTjo^; %^ jaAjasqo aniT:^TJBra 
pnB x^<)I§oiojoapin aq; jo Bi^Bp aq:^ i!q paqsT[qB|sa st :^obj 
aqj^ '9idi:)j\[-9uuY aq:} uiojj puTi\i aq; nxViop panoT:^B:^s aja^vi 
sdiqs papajni aq:^ xi^ ^^^^ Aioqs ajiBZBj^^4urBg c^b aimapida 
aq; JO spjooaj aq:^ ^Bq:^ ^obj aq^ :^no s5aijq jaSB^ -jq 

•q^2 jaq 
-raa^dag paip pnB ^q;6S ^snSny ^ni tiai[B; sbai oqAi '91j/dj\[ 
-duuy aq:^ ^'nT:|.BSTninj puB SuiuBaxa ui pa^Coxdma uani aq:^ 
JO auo S.q paqsTUjnj SB.\i oiinapTda stq:^ jo oqaa :^sbx aqj^ 

•q^Bap £q x^aioxxoj ^asBO :^sbx pnB q:^qSTa ^q^oS 
jaqina:^dag no -i^jaAooaj tsasBD q;naAas pnB q^xrs ^q^oS 
pnB qi^xi Jaqnia^dag no 'AjaAooaj fxil na5[B:^ sbai x^ssaA 
aq^ JO niB^dBD aq| ^qi^xi *t9qnia:^dag no 'if JaAOoaj i pajjna 
-00 asBD q^jnoj aq; ^q:^6S ^^snSny no "iljaAoaaj ipdipvq. 
4B SBAi aoTi^najddB nB q;9^ :^sn§ny no *q^08 ^^^ 
no q^Bap Aq pa.^oxxoj 'pajjnoao 'Aoq-nrqBO b jo nosjad aq^ 
UT ^asBD pnoaas b *pn^g c^snSny no 'oiaiapTda axqBJoniani 
siq:^ JO sjaxoinojqo aq:^ £q naAiS :^on si qaiqAi asuBa anios 
joj paniBi^ap naaq pBq x^ssaA aq; ajaq.\i ^i£noasBO J^ iV^D 
aq:^ ni XXT^^ ^^^^ xassaA aq:^ ^l]^^ ^^^OT sq^ no paip pnB JOAaj 
q;T.vi xiT nai[B:^ SBi\i Jaa^o pnoaas aq:^ ^:^snSny jo q^g aq:^ 
no 'BOTjamy q;nog ^annai^BQ joj paxiBS udptbduy aq; 
^;sx ;snSny no 'pagjBqasip Sniaq sbai oSjbo s^ja;;BX aq; 
axiq^^L ^9tdi}j\[-duuy aq; apisSnoxB pajooni aqs ^;sx ;snSny 
o; q;9^ i^xi^r fcaojj '2Z ^^^£ no ^ajiBZB^-;nTBg ;b paAij 
-JB ^anoaq; BJjaig mojj nBni;nBqajani b '^vdinbduy aqx 

•pajaAooaj i^x^^inb pnB 5[aB;;'B piini 
B pBq oqAi ^iloq-niqBa b jo ;Bq; ^nBni;nBqojani aq; jo pjBoq 
no padoxaAap asBa ano ^^x^O *9Joqs aq; niojj pnB o; i!BAi 
-aSBSSBd B SB xassaA paniBn aAoqB aq; asn o; paxxadnioa ajaAi 
S9ii9uvpj/D(j aq; jo A^aja aq; ^9tuvi\[-9nny aq; jo apis ajoqs 
-^o aq; no Sniag 'oSjBa jaq SniSjBqasTp sbai oidvj^-duuy 
aq; ajaqAi nisBq amBs aq; ni joqanB paqSTai\i ^Banjno 
JO jxno oq; mojj nBni;nBqajani b ^soudiwpuvQ aqx 

90t *T98I — aHivzvN xnivs — sdnvh^ 



•pjBoq ao sasBo jeq^o o^ -if jeAooaj 
Xnj:^naAann ub apBui i!aqjj -jaAaj iVioip^ Pi™ jo sraio:j(iini!s 
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•HaAHJ MOnSA AO AHOiSIH f Ot 



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•inaq:^ SnoniE pajjnoDO saii^i 
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aq; Ja^jB s^Bp o.ii; ^g^ liu£ no paxiBS 3iid:}.sdi[Q aqx 
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aq; jo aoTAjas aq; ni ;Boq Sn; nBvas b '^/jiiv^smiQ aqx 

: sxassaA Snmoxxoj aq; ajaM 
'joqanB ;b sb.m 9idvj\^-9uuy aq; ajaq.\i nisBq aniBS aq; nj 
•ajiBZBjsj;-;nTBg ;b s;naAa aq; dn aqB; Aion xi^^s dj^ 

'onu0pid[j di[j, 

got '1981 3HIVZVN XNIVS aONVH^I 



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aqa ni ajijp oa pappap ^.iiajo aqa a§aj oa japjo ni ^nirndBO 
aqa *'snrej Aq x^^^onoj smjoas pn^ smpa Snifrojq jo sa"bp 
aA^ 'noTaB^iABn SA^p aA^ JaajY 'o^jbd aqa ssajp Ayja 
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B qai-^ 'saanBX Jo ajod aqa jo diqs b '9jj.dj\;-juuy aqx 

-[^: pnBja j-jaSnajag pnB ^^ja^B^ 
j!q naAi5 sannooB Sniasajaani aqa mojj pnB g.^Jaiiax'C 
JO :^J0-Si aAisnaqajdmoo aqa mojj amnsaj SniAiOXjoj aq; 
XXno Bj^ -oimapida siqa anoqB naaaij-ii naaq SBq qauj^^ 

lOV *I98I — STIIVZVX XXIV? 3D.S:VHJ 



417 

LOCALITIES IN( GKEAT BEITAIN WHEKE YEL- 
LOAV FEVER UA^ BEEN OBSEEVED. 

England. 

Dover. A seaport and parliamentary borough, on the 
northwest side of Dover Strait, County Kent, sixty-six 
miles southeast of London and twenty- one miles from 
Calais, France. It is an important railway terminus, and 
as a port for mail and railway service with the Conti- 
nent, has a large) passenger traffic. Population : 1881, 
28,486; 1891, 33,418. 

Falmouth. A seaport, in Cornwall, on Falmouth Bay, 
on the southern side of the estuary of the Fall River, 
sixty-six miles by rail southwest of Plymouth, and 250 
miles from London. From 1688 to 1850, Falmouth was 
an important packet station, but it is now chiefly a port 
of call. It has a fine roadstead, affording excellent refuge 
for shipping. Population: 1891, 4,273. 

Isle of Wight. An island in the English Channel, off 
the south coast of Hampshire, separated from the main- 
land by The Solent and Spithead. 

London. Capital of the British Empire and the largest 
city in the world. It is situated in the southeast of 
England, on both sides of the River Thames. It is difficult 
to assign any exact limits to London, on account of its 
straggling form and numerous suburban extensions; but 
it may be said to stretch fromi east to west about fourteen 
miles and from north to south about ten. Population: 
1881, 3,816,483; 1900, 4,546,752; 1907, (estimated), 
7,217,941. 

Motherhank. A shoal off the south coast of England, 
between the mainland and the Isle of Wight. 

'Neiocastle-on-Tyne. A city in the northeast of England, 
Northumberland County, on the left bank of the Tyne 
OEliver, about eight miles from the North Sea. It is an 
extensive manufacturing center. Within the city and 
vicinity are numerous blast furnaces and malleable and 



418 HISTORY OF YELLOW FEVER. 

other iron foundries. Population: 1891, 186,345; 1907, 
(estimated), 264,511. 

Salcomhe, A town in Devon. 

Southampton. An important seaport near the English 
Channel, in Hampshire, on a peninsula at the mouth of 
the Itchen Elver, near t^e head of Southampton Water. 
It is seventy-one m|iles southwest of London. The town 
is a rendezvous for many steam packet lines and is much 
visited by ocean steamers. It has extensive docks and is 
an emigrant station. The Eoyal Mail Steamers ply regu- 
larly between Southampton and the West Indies. Popu- 
lation; 1891, 65,325; 1907 (estimated), 119,745. 

Woolioich. This was formerly a naval port of England, 
County of Kent on the Thames, seven miles southeast of 
Saint Paul's Cathedral, London. It is now a part of the 
metropolis. The chief importance of the place lies in the 
fact that it is the seat of the Eoyal Arsenal, founded in 
1585, which employs about 12,000 men, whose wages ex- 
ceed 1350,000 a month. 

Ireland. 

Cor7<^. A river-port of Ireland, capital of the County 
of Cork, 137 miles southwest of Dublin, j Population: 
1881, 80,124 ; 1891, 75,070. 

Duhlin. CapitaJ of/ Ireland, on the Liffey Eiver, by 
which it is separated into two nearly equal parts. Popu- 
lation: 1891, 254,709; 1907, (estimated), 378,994. 

Wales. 

N 

Llanelly. A seaport town of Wales, an a creek empty- 
ing in Carmarthen Bay, fifteen miles of Carmarthen. 
Population: 14,973. 

Sicansea. A seaport of Wales, County of Glamorgan, 
on the west side of the Tawe, at its mouth in Swansea 
Bay, Bristol Channel. It is an important commercial 
center and is connected with London by rail. Population : 
1871, 51,702; 1881, 59,597; 1891, 90,349. 



419 

ENGLAND. 

DOVEE. 

. 1878. 

iln 1878, yellow (fever was almost brought to the town 
of Dover. A Norwegian ship, on which there had been 
thrde deaths from th^ disease on the passage from Kio 
de Janeiro, entered tho^' port without being subjected to 
quarantine measures. Fortunately, no cases erupted on 
board while the vessel was in the harbor.^ 

FALMOUTH. 

1817. 

The brig Britannia, from the West Indies, after having 
touched at Liverpool, arrived at Falmouth. She remained 
in that port six weeks before beginning to discharge her 
cargo, which consisted principally of cotton. No sooner 
ihad the unloading begun than yellow fever developed on 
board. The disease was limited to the crew of the vessel.^ 

1864. 

A ship from Sierra Leone brought a case of yellow fever 
to Falmouth in 1864. The patient died.^ 

ISLE OF WIGHT. 

1845. 

In 1845, the ship Eclair, which later in the year in- 
fected the Cape Verd Island (q. v.), brought yellow fever 
to the Isle of Wight. A pilot and a doctor who had come 
from shore to the vessel were attacked, but recovered. 
The outbreak was limited to these two cases.^ 

^Berenger-Feraud: Traite Theorique et Pratique de la Fievre 

Jaune (Paris, 1890), p. 158. 
^ Eager: Bulletin No. 8, Yellow Fever Institute (WasWngton, 

D. C), 1902, p. 32. 
^ Berenger-Feraud, loc. cit., p". 141. 
* Berenger-Feraud, p. 117. 



420 

LONDON. 

1713. 

Currie^ (page 64) asserts that yellow fever was brought 
to> London by ^'a. vessel^in 1713, but that the disease did 
not spread beyond the imx^orted cases. The information 
is very indefinite, not even giving the name of the vessel, 
the number of sick or the original source of infection. 
A careful survey of this and the other books of Currie 
indicates that this is the only place in which mention is 
made of yellow fever in London. ^ 

1878. 

The only authentic case of yellow fever ever observed 
in London, is commented upon at length by Leggatt and 
Greenfield^ in the Transactions of the Clinical Society of 
London^ for 1878. 

The patient, D., a retired army officer, was in the habit 
of spending the winter months in a warm climate and 
for two years previous to his illness had done so in South 
America. Leaving England January 9, 1878, he landed 
at Rio de Janeiro on the 30th of the same -month and then 
went to Buenos Ayres. He returned to Rio on February 
21. Yellow fever was then epidemic in the town and 
shipping. He left Rio on February 24, arrived at Lisbon 
on March 14, and at Southampton on the 17th. He 

^Currie: A Sketch of the Rise and Progress of the Yellow 
Fever, and of the Proceedings of the Board of Health, 
in Philadelphia, in the Year 1799; to which is added a 
Collection of Facts and Observations Respecting the 
Origin of the Yellow Fever in this Country; and a Re- 
view of the Different Modes of Treating it, 
Philadelphia: Printed by Budd and Bartram, No. 58 North 
Second Street, 1800. 

^Legatt and Greenfield: "A Fatal Case of Yellow Fever Oc- 
curing in London." — Transactions of the Clinical Society 
of London, 1878, p. 187. 



LONDON, ENGLAND 1878. 421 

reached London, March 18, was taken ill on the 21st, and 
died on the 27th. 

The autopsy disclosed a typical case of yellow fever. 

What puzzled the English doctors who attended this 
case, was the seemingly long incubation of the germ of 
yellow fever, about twenty-live days, according to their 
computation. They calculated the probable date of in- 
fection to have been February 24, the day of D.'s departure 
from Kio. The fallacy of this conclusion is proved by a 
reference to an extract from the diary of the officer, 
published in the article from which this account is taken. 
It seems that on February 12, while the ship on which 
he had taken passage was at Buenos Ayres, the assistant 
purser died of yellow fever. The Vessel left Buenos 
Ayres, February 15 and arrived at Rio on the 21st and 
sailed for England on the 24th. Two days later, two of 
the crew, who had never left the vessel since her departure 
from England, were stricken with yellow fever. One re- 
covered; the other died on March 5. No other cases 
erupted on board. ) 

Fromi the above, it is certain that D. did not contract 
the disease at Rio, but was infected on board the vessel 
on which he was a passenger a few days after the death of 
the third case (March 5). This would give an incubation 
of nine or ten days. 

NFWCASTLE-ON-TYNE. 

1895. 

Much apprehension was caused in England in 1865 
by the announcement that the Norwegian ship Mindet, 
from Mobile, Alabama, which arrived at Newcastle-on- 
Tyne in November of that year, had yellow fever on board. 
An investigation by the health officers of the town revealed 
the fact that eleven men were suffering from malarial 
fever and that two had died of this disease on the pas- 
sage from Mobile. The eleven men were removed to the 



452 HISTORY OF IlTLLOW FEVF.R. 

Tviie Port floating hospital, as a preoaiitionarT measure. 
All recovered.'' 

There was no vellow fever in Mobile in 1S65. and as the 
Mindet did not totieh at any i»rt on the xvip to Xeweastle- 
on-Tyne. the diagnosis of malaria was imdoubtedlT 
correct. 

POETSMOUTH. 

17G3. 

Legallois^ says that the war vessels returning from 
America in the fall of 1763, landed at the Haslar Hospital, 
near Portsmouth, several seamen sick with yellow fever, 
The hospital being overcrowded, it was found impossible 
to segregate these patients, but in spite of this lack of 
precaution, the disease was confined to the imported cases. 
The number of cases and deaths is not given. 

. 1S27. 

La Pioche^' quoting Xiel/-'' relates a case of fever which 
occurred at Portsmouth in July, 1827, during a very hot 
spell of weather. In this case, which was of very severe 
character, there was jaun<iice and other symptoms, which 
gave it somewhat the character of yellow fever. The 
patient was attacked to the night of the 8th : on the 15th, 
he vomited thrice in the night, the matter being black 
like coffee grounds. The stools assumed the same appear- 
ance. After twenty days of sickness, the patient 
recovered. 



•Campbell: V.S. Public Health Reports (Washin^on, D. C), 

1895, vol/ 10, p. 1150. 
^Legallois: Rochercbes sur la contagion de la Fievre Jaune 

(reprint), Paris, 1S50, p^ 20 (foot note). 
•La Roche: Yellow Fever (Philadelphia, 1855), vol. 1, p. 274. 
"*Neil: London Med^ & Phys. Journal, X. S., vol. 5, p. 105. 



ENGLAND 176S. 423 

Had this case occurred in New Orleans or any other 
locality where the disease has been observed from time 
to time, it would have been unhesitatingly pronounced 
yellow fever. It is one of the many examx>les which goes 
to prove how difficult it is to arrive at a correct diagnosis 
of the saffron pest. 

SALCOMBE. 

1877. 

In the beginning of 1877, a German sailor was landed 
at Salcombe, Devon, from the schooner St. Lucia, from 
the West Indies, suffering from fever. iHe was taken to 
the workhouse infirmary at Kingsbridge. Unmistakable 
symptoms of yellow fever having manifested themselves, 
all the other inmates were removed from the hospital, and 
the Board of Trade was communicated with. The patient 
recovered and no other case resulted. 

SOUTHAMPTOM. 

Yellow Fever Years. 
1852; 1853; 1857; 1860; 1861; 1866; 1867. 
Summary of Importations. 

1852. 

It is surprising that Southampton, which has extensive 
commercial relations with the West Indies, South America 
and the West Coast of Africa, all notorious foci of yellow 
fever infection, should not have been invaded by the dis- 
ease prior to 1852. The iiassenger traffic between the town 
and the countries above mentioned is very active and as 
hardly any precautions are taken when a ship from these 
localities arrives at the port, unless yellow fever is present 
or has been raging on board dui'ing the voyage, there is 
no doubt in our mind that outbreaks of vellow fever have 



424 HISTORY OF YELLOW FEVER. 

occurred at dates anterior to 1852 and were put down by 
the authorities as "typhus" or "malignant fever," either 
through ignorance of the symptomatology of the tropical 
plague or through a wanton desire to conceal the real 
state of things. The slogan of the British nosologists is 
"No Quarantine," as they hold -that the ship alone and 
not the place whence it comes should be held under sus- 
picion and though yellow fever may be committing fear- 
ful ravages in a certain place, no barrier is put upon ves- 
sels arriving therefrom, unless the vessel itself is known 
to be infected. Owing to the swiftness with which trans- 
Atlantic vessels make the voyage from America these 
days, a ship may be a slumbering nidus of infection and 
a detention of two days, which is the usual custom in 
England, is hardly sufficienit to jjlace a ban on the impor- 
tation of the disease. The only thing which saves South- 
am tpon, London and other ports of the Empire from a 
devastating invasion of yellow fever, is the fact that the 
Stegomyia calojms is either totally absent (or is present 
in such small quantities in these localities, that even when 
importation does take place, there is no agent present to 
disseminate the virus and the invasion ends with the 
original cases. 

The solitary case which erupted in the very heart of 
Southampton in 1852, substantiates the above assumption. 
Had this incident happened in New Orleans, which is now 
as free from the disease as Boston, New York or Phila- 
delphia, but which was then a hot-bed of pestilence, it 
would have created a focus whence the poison would have 
been carried to every section of the city. To the Ste- 
gomyia calopus, New Orleans owes the terrible carnage 
caused by yellow fever in the past and to the strict quar- 
antine regulations and the almost total annihilation of 
the winged carriers of contagion, does she owe her present 
freedom from a disease which at one time was said to be 
endemic. j 



SOUTHAMPTON, ENGLAND 1852. 425 

The history of the infection of Southampton in 1852 is 
as follows :^^ 

On the morning of the 18th of Xovember, 1852, the 
Eojal Mail Steampacket Company's ship La Plata ar- 
rived at Southampton from the West Indies, with the loss, 
from yellow fever, on the homeward voyage, of her com- 
mander, together with six of the crew. She had left 
Southampton on the 18th of October (exactly one month 
previously), and gone directly to the Island of Saint 
Thomas, which she reached in thirteen days; and remain- 
ing there four or five days, sailed again on the 4th of 
November for Southampton. 

This was the second voyage of the La Plata from 
England to the West Indies. The vessel was new and 
the crew, when she left Southampton in October, were in 
perfect health. Yellow fever was then prevailing both in 
the town of Saint Thomas and among the shippino' in 
the harbor. During the time the La Plata lay in the West 
Indian port, her officers and crew communicated freely 
with the people on shore and with the crew of some of 
the adjacent ships. Moreover, just before leaving England, 
she received on board a considerable number of invalids 
from the Great Western, the Thames and the Esk — ships 
belonging'to the Eoyal Mail Company — as likewise from 
the war-steamer Highflyer, All these invalids were re- 
covering from fever and one was actually ill at the time 
of the transfer (November 5th), had black vomit the next 
day and died on the day following. 

Within twelve hours after the La Plata steamed from 
Saint Thomas, on the 5th of November, the second en- 
gineer fell ill with yellow fever. The captain was attacked 
on the 8th. The same day, the purser and two coal trim- 
mers were seized, and each of the five days following fur- 
nished fresh cases of the disease. In all, fifteen cases 
occurred during the passage from the 4th to the 13th of 
November, of which seven proved fatal. 

"Harvey: Lancet (London), 1853, vol. 1, p. 148; Phillips: 
Ibid., p. 2931; Milroy: Ibid., 460. 



426 HISTORY OF YELLOW FEVER. 

When the La Plata arrived at Southaimipton, the above 
particulars were communicated to the quarantine officer 
of the port, and the vessel was placed in quarantine till 
the morning of the 20th, when she was released. 

The distressing intelligence thus conveyed by the La 
Plata, and the fact that yellow fever was through her 
brought almost to the doors of the town, created intense 
excitement, as well in the kingdom at large as at South- 
ampton. And this feeling had scarce began to subside 
when it was heightened by the occurrence, in the town 
of Southampton itself, eight days after the release of the 
vessel from quarantine, of an unequivocal case of yellow 
fever affecting and proving fatal to Mr. Xapier, fourth 
engineer of the La Plata. 

It was impossible to be without misgivings as to the con- 
dition in which the steamers next in succession from the 
West Indies might arrive and accordingly their advent 
was looked forward to with greatest anxiety. Unfor- 
tunately, the worst fears were realized. The Medway, 
the Orinoco, the Magdalena, and the Parana, which suc- 
cessively came in, all gave histories of having suffered 
more or less from the fever. Xot to go into details respect- 
ing them, it may be observed that including the La Plata, 
the several steamers furnished an aggregate of about 124 
cases, of which about 50 ended fatally. 

The particulars of the sickness and death of Mr. Napier 
are as follows : 

The La Plata arrived at Southampton on the 18th of 
November, 1852. Amongst her officers was Mr. Napier, 
who was engaged in the engineer's department. He took 
lodgings in town, where he slept at night. During the 
day he was occupied on some work in the engine room, 
in the lowest part of the vessel, wliere he no doubt was 
bitten by the infected mosquitoes who had retreated to 
the warmest part of the ship to escape the cold, the winter 
season being then at its heig]ht. ^He was taken ill at his 
lodgings on the 28th of November. On the evening of the 
3rd of December, he vomited black matter and died on 
the morning of the 5th. 



SOUTHAMPTON, ENGLAND 1852. 427 

When the news of this death reached the public, South- 
ampton was in an uproar almost bordering on panic and 
all sorts of wild rumors were circulated. Every case of 
fever was looked upon with suspicion and it only needed 
the eruption of a second case to cause an exodus of the 
population. A report was spread that the woman who 
had nursed the unfortunate engineer had been seized with 
yellow fever, but when the rumor was sifted, it was found 
that a woman had been engaged to attend to the patient, 
but left the house and the landlady had taken her place. 
She was not in good health when she began her minis- 
trations and having to attend the patient day and night, 
the fatigue incidental to her arduous task rendered her 
ill. This indisposition was magnified by the excited pop- 
ulace into a case of black vomit and it was only when 
the health authorities publicly announced that the rumor 
was false, that the excitement subsided. One good trait 
of the English people, is their unshakable faith in the word 
of their health guardians, and even if the woman really 
had yellow fever, the mere fact that a representative of 
Her Majesty said that she did not, was suflflcient. There 
was no "going behind the returns," as we do in America. 

The case of Mr. Napier was the first and last manifesta- 
tion of yellow fever in Southampton in 1852. 

1853. 

During 1853, yellow fever continued to rage in the West 
Indies, particularly at Kingston, Jamaica, where the ves- 
sels of the Koyal Mqil Company continued to be infected, 
as in 1852. According to the reports published in the 
Lancet y British Medical Journal and London Medical 
Gazette, for 1853, we glean the fact that the following 
vessels had yellow fever on board on their homeward voy- 
age from America : 

January — —. The Parana. Infected at Saint Thomas. 
Thirty cases; four deaths. On arrival at Southampton, 
thirteen invalids were transferred from the vessel to the 



428 HISTORY OF YELLOW FEVER. 

Marine Hospital. All recovered and no other cases 
occurred. 

May 17th. The Severn. Infected at Kio Janeiro or at 
Saint Thomas. Six cases; no deaths. Last case, May 
2nd. Fifteen days haying elapsed since the last case, tl ^ 
vessel was admitted to pratique, after a rigid examina- 
tion. Xo other cases erupted. ( 

May 18th. The Orinoco, Infected at Saint Thomas. 
Fourteen cases; two deaths. One of the invalids being 
^^as yellow as a guinea," when the Orinoco reached South- 
ampton, the vessel was detained at quarantine for four 
hours, pending an investigation. A release was then 
given, but the "'saffron man" was sent to the quarantine 
station and the yellow flag hoisted. A guard was sta- 
tioned to prevent any possibility of escape, but the i)atient 
improving rapidly, was released after a detention of two 
days. No other cases erupted while the Orinoco was at 
Southampton, but the vessel was reinfected a few weeks 
afterwards, as we shall see later. 

May 30. The La. Plata. Infected at Saint Thomas. 
This is the steamer which imported the celebrated case of 
Mr. Xapier to Southampton in 1852. On arrival at the 
quarantine station, it was learned that there had been 
fourteen cases and three deaths on board since May 7th, 
the date of the first case. The last case had occurred on 
the 24th, and the last death on the 30th, the day of her 
arrival at Sotithampton. Immediately after the conclu- 
sion of the investigation, the mails were landed, but the 
ship was detained at quarantine and the facts communi- 
cated to the Privy Council Office. Orders were received 
from London to release the healthy passengers at once, 
but to detain the ship until the afternoon, in order to com- 
plete the stir>ulated six days from the otitbreak of the 
last case. The invalids were eventually transferred to 
the !^^arine Hospital. Xo new cases ensued. 

July 17th. The Orinoco, This is the same vessel 
which had had fourteen cases and two deaths on a previous 



SOUTHAMPTON, ENGLAND 1853. 429 

voyage, noted above. On arriving at quarantine, the fact 
Avas elicited that the first case had appeared on the day 
after the ship arrived at Saint Thomas, in the person of 
a seaman. This evidently does away with the assump- 
tion that the vessel was infected at Saint Thomas in this 
instance, as yellow fever certainly takes more than twenty- 
four hours after infection to manifest itself, ^e that as 
it may, during the remainder of her stay at Saint Thomas, 
no less than thirty cases occurred, confined principally to 
the seamen and stokers. After leaving Saint Thomas, 
fifteen fresh cases erupted, among which was. a passenger. 
The forepeak of the steamer was fitted up and used as a 
hospital during the time the ship w^as in the harbor of 
Saint Thomas; but on her leaving, the heat being exces- 
sive from the closing of the ports, the sick were removed 
to the deck, where awnings were spread. This was at- 
tended by a diminution of the sickness, which finally dis- 
appeared altogether. 

The Southampton authorities took extraordinary pre- 
cautions to prevent the disease from spreading to the 
shore. All persons on board, in good health, who made 
a sworn declaration that they had had, in their lives, 
anything like yellow fever, were permitted to land at 
once. Those who could not do so, were put under sur- 
veilance and allowed to proceed on their way only after 
a rigid examination. 

The disease was not communicated to the shore. 

1857. 

The steamship Tamm\ which brought yellow fever to 
Lisbon, Portugal, in 1857 (q. v.), entered Southampton 
shortly afterwards.^^ She had deaths on the passage 
from Spain and gave rise to several cases of yellow fever 
in the harbor of Southampton. 



"Eager: Yellow Fever Institute Bulletin No. 8, Washington, 
D. C, 1902, p. 33. 



430 HISTORY OF YELLOW FEVER. 

1860. 

On April 3rd, 1860, the Eoyal Mail Steamer Tyne ar- 
riyed at Southampton with yellow fever on board. Eight 
cases, with three deaths, had occurred during the home- 
Yfard voyage. One of the passengers was seized only eight 
days before the arrival of the ship at Southampton. Three 
of the patients, in an extremely debilitated condition, were 
sent to the Marine Hospital, where they eventually recov- 
ered.^^ [No new cases manifested themselves while the 
Tyne was at Southampton. 

IRELAND. 

COKK. 
1854. 

A solitary instance of yellow fever having been brought 
to Ireland is recorded. 

In 1854, according to the Lancet (London), vol. 1, page 
90, 1854, a vessel entered the harbor of Cork, with yellow 
fever on board. Two patients, who were transferred from 
the ship to the Marine Hospital, died. This incident 
created much alarm among the inhabitants of the town 
and prompt and extraordinary precautions were adopted 
to prevent a spread of the disease. No other cases 
erupted. 

DUBLIN. 

1857. 

Cummins^^ relates a case which came under his obser- 
vation at Dublin in 1857, which presented all the charac- 

" Lancet (London), 1860, vol. 1, p. 386. 

^'^ Cummins: Case of Fever, with Unusual Symptoms. Dublin 
Quar. Jl. of Med. Sciences, 1858, vol. 26, p. 212. 



IRELAND, 1857. 431 

teristics of yellow fever. The patient, a boy five years 
old, had exhibited sj^mptoms of ill health for some months 
previons, consisting of debility, loss of appetite and shoot- 
ing pains in various parts of the body. These symptoms 
were given proper attention by Dr. Cummins, but with- 
out much decided or permanent improvement. On De- 
cember 2, 1857, the little patient developed a fever which 
seemed to be of a gxave nature. ^'From day to day, as I 
watched the progress of the symptoms," observes Dr. Cum- 
mins, ^'I became more and more reminded of that disease 
which numbers its victims by thousands within the trop- 
ics, but rarely carries its devastations to more temperate 
regions, and as yet has only been observed in isolated cases 
in this country." 

The Doctor did not at the time suspect that he was 
dealing with a case of yellow fever, and did not treat it 
as such, but remarks that if the case had occurred in any 
of the habitats of yellow fever, there would not have 
been a second opinion about pronouncing it to be that 
disease. 

The patient died on December 9th, seven days after 
the graver symptoms of his illness had manifested them- 
selves. Shortly before death, he had black vomit. 

At the time of the above occurrence, yellow fever, having 
transgressed its ordinary bounds, had visited Southern 
Europe and was making fearful ravages in Lisbon. Our 
authority does not give the probable source of infection 
in the case under observation, leaving one under the 
impression that it originated in Dublin. Such could not 
possibly happen, however, under the most vivid stretch of 
the imagination. If the case was one of yellow fever, 
there is but one way in which it could have been engen- 
dered. We regret our inability to either verify or dis- 
prove the question at issue, as the literature of the period 
fails to enlighten us in that direction. 



432 

WALES. 

; LLANELY. 

1865. 

While the yellow fever was causing widespread con- 
sternation at Swansea (q. t.)? the sloop Eleonorej which 
lay close to the Hecla, from September 16th to the 18th, 
was infected and carried the disease to Llanely.^^ Charles 
Hayes, John Slocum and Daniel Stapleton, sailors on 
board the sloop, were attacked. ll\ie'FAeonore sailed for 
Llanely, where two of the patients died.^*' 

SWANSEA. 

Yellow Fever Years. 

1813; 1851; 1861; 1865. 

1813. 

On July 26th, 1813, the brig Pirie, from Cuba, arrived 
at Swansea, with a cargo of copper ore. Some of the 
crew had died from yellow fever on the homeward voyage. 
Benjamin Davies, a Swansea pilot, boarded the vessel 
on her arrival, remained on board that day at the Mumbles 
Koad, entered the harbor the following day, the 27th. . He 
repaired to his home as soon as the ship was moored. He 
felt indisposed, complaining of violent pain in the head 
and died on the 28th, exhibiting all the symptoms of 
vellow fever.^^ 



^«Donnet: Arch, de Med. Navale, 1870, vol. 14, p. 118. 
"Buchanan: Eighth Report of the Medical Officer of the Privy 

Council for 1865 (London, 1866), p. 443. 
^^ Buchanan, loc. cit., p. 443. 



SWANSEA, WALES 1851. 433 



1851. 

The bark Henrietta, from Cuba, arrived at Swansea in 
the month of August, 1851, with a cargo of copper ore. 
William Gammon, a sailor, was employed to go on board 
as ship'-keeper. While attending to his duties, he was taken 
ill, went home on August 25th, and died the next day, 
an unmistakable victim of yellow fever. 

A second^case developed on the Henrietta. When Gam- 
mon was first taken ill, his brother, also a sailor, not sus- 
pecting the njature of his relative's illness, went on board 
the vessel to take his place. He was also taken ill, but 
having obtained the prompt service of three doctors, as 
well as that of the ship's old captain, recovered. His 
illness is said to have been yellow fever.^^ 

No other cases erupted on board the Henrietta nor was 
the disease diffused on shore. 



1862. 



During the year 1862, the following vessels arrived at 
Swansea with histories of yellow fever on board :^" 

The San Jose lost two of her crew from yellow fever at 
Cuba. 

The Florence, one. 

The Cornwall, ten, five in Cuban ports and five at sea 
on the homeward voyage. \ 

The Ellen, eight, seven at Havana and one on the pas- 
sage homie. 

The Hampshire^ one. 

The Mamgosteen, one. 

The Countess of Bective, five. 

The Dorsetshire, four. 

The Qohrero, four. ', 



" Buchanan, loc. cit., p. 443. 
"Buchanan, loc. cit, p. 444. 



434 HISTORY OF YELLOW FEVER. 



1863. 



The year 1863, although not as prolific as 1862, fur- 
iiished the following :^i ^ 

The Florence lost one man at Cuba from yellow fever.. 
The Stains Castle^, one. 

The Cornwall^ three, two at Cuba and one on the way 
home. 

The San Jose, one^ at Cuba. 

1864. 

In July, 1864, the bark MangosteeUj from Cuba, ar- 
rived at Swansea, with a history of yellow fever on board 
during the homeward voyage. Samuel Daw^kin, a ship- 
keeper, was placed in charge of the vessel. He was soon 
taken ill and died on the third day.^^ 

The following vessels also furnished histories of yellow 
fever infection in 1864 1^^ 

The Dorsetshire, two at Cuba. 

The Mangosteen, one, at sea. 

The Pedro Ferrer, one, at Cuba. 

1865. 
The Famous Case of the ''^Hecla.^-' 

The year 1865 furnished the only epidemic of yellow^ 
fever which has ever flourished on English soil. We shall, 
therefore, make free use of Dr. Buchanan's masterly re- 
port of the incident.^* The facts as condensed from the 
voluminous document in question, are as follows : 

^^ Buchanan, loc. cit, p. 444. 
^^ Buchanan, loc. cit., p. 443. 
=^' Buchanan, loc. cit, p. 444. 
" Buchanan : Report on the Swansea Fever, published in -Eighth 

Report of the Medical Officer of the Privy Council for 

1865 (London, 1866), p. 442, et. seq. 



SWANSEA, WALES 1865. 435 

The bark Eecla, a wooden sailing vessel, returning from 
Cuba to Swansea with a cargo of copper ore, arrived at 
the British port September 8, 1865. The vessel was 
boarded at 5 P. M., by George Morgan, a Swansea pilot, 
fifteen miles to N. E. of Lundy Island (about twenty-five 
miles off Swansea) Morgan found the ship in charge of a 
Bristol Channel pilot, who gave up his post and returned 
to his own boat. The master informed Morgan that he 
had a man sick with dropsy on board, that he had lost 
three of his crew on the voyage home, was in consequence 
short-handed, and desired the pilot to send his boat ashore 
for four or five men to assist him in coming in. This 
was accordingly done and the five men boarded the Eecla. 
The vessel anchored in the, Mumbles roadstead, about 9 
P. M., and showed a light through the night. At daylight 
on Saturday, September 9, the ensign was hoisted, and the 
ship's number shown. IThe steam tug came up about 6 
A. M., and towed the Eecla in, in the ordinary course^ 
Not a word was said to the pilot about yellow fever, and 
he had no idea that the men died of that disease. The 
last vessel that had arrived from Cuba, less than a fort- 
night before, had had no sickness on board, and the pilot 
had no reason, particularly as the Eecla. had a clean bill 
of health, to believe that the sickness on board was of an 
infectious character. 

The Eecla entered Swansea harbor at 9 A. M., on Sep- 
tember 9, showing no quarantine flag, and giving no in- 
dication that sickness was on board. She was placed in 
the North Dock, alongside the Cobre Wharf, in the usual 
discharging berth. A good many people went on board 
as she entered the dock. Within an hour of the ship's 
arrival, two passengers were landed with their baggalge, 
and the crew had left the ship, and had distributed them- 
selves over the town. Three men were landed sick; two 
of whom were recovering from "fever;'' one the captain) 
reported ill of dropsy. Within three hours of the vessel's 
arrival in port the hatches Avere removed, a stage rigged] 
and gangs of men commenced discharging the cargo. 
About noon the sanitary inspector came to the mayor, 



436 HISTORY OF YELLOW FEVER. 

told him of the arrival of the EeclWy and stated to him 
that deaths were reported to have occurred on the vessel 
in her homeward passage, and that one seaman had been 
landed from the ship seriously ill. The mlayor went at 
once to the collector of customs and to the master of the 
Hecla, and learned that the rumor about sickness on board 
was true, that some of the deaths had been from yellow 
fever, and that the sick seaman was suspected to be suf- 
fering from the same disease. Thereupon the mayor re- 
quested Dr. Paddon to accompany him, and they wenlj 
together to Welcome Court, where the man, James Saun- 
ders, who had been removed from the Hecla^ lay sick. He 
had before been visited by two medical men ( Messrs. Har- 
rington and Thomias ) . This was the man who was stated 
by the captain to be ill of dropsy. Dr. Paddon found him 
in bed, in a wretched room of a small filthy house, dying 
of exhaustion from fever, without any sign of dropsy; 
his body tinged yellow. He was so near death that no 
detailed examination could be made. The ma^^or and Dr. 
Paddon had scarcely left the house when the people ran 
after them, to say that Saunders was dead. Dr. Paddon 
thereupon certified that he died of ''fever, probably yellow 
fever." 

At this time, soon after noon on September 9, a good 
deal of public anxiety existed about the Hecla, and about 
the possibility of the disease spreading from the house in 
Welcome Court or from the crew. Under Dr. Paddon's 
advice, the mayor caused the following precautions to be 
taken : The body of Saunders was put into a tarred sheet, 
and buried within four hours of his death; the house 
where he died was immediately emptied, and disinfected 
with limewash and chloride of lime and, for further safety 
all the houses in the court were similarly treated. |The 
bedding and clothing of the dead man were destroyed, 
and the house was again cleansed and disinfected before 
it was allowed to be tenanted, a week after. The mayor 
also set the police to find out the passengers and crew of 
the Hecla, instructed the sanitary inspector to have their 
clothes and rooms and persons fumigated with chlorine. 



SWANSEA, WALES — 1865. 4S7 

But the mayor and Dr. Paddon were further desirous 
of dealing with the Eecla herself, on the supposition that 
she might be a source of infection. The mayor therefore 
convened a meeting of magistrates, to consider whether 
there was any power to remove the vessel from the dock, 
and if so, whether the sailors who had left the ship could 
be compelled, under their articles, to take her out. The 
customs authorities and the board of health were also 
applied to. All agreed that the vessel ought never to 
have come into port, but having entered and partly dis- 
charged her cargo, the authorities found themselves 
powerless to insist on her removal. The agents for the 
owners of the ship and cargo were communicated with, 
but they at first refused to allow either ship or cargo to 
be meddled with, arguing that other ships had come into 
Swansea having had yellow^ fever on board on their home- 
ward passage, that they had never been interfered with, 
and that no ill results from them had occurred to inhabi- 
tants of the town. After consultation with other auhori- 
ties of the town, the mayor on the afternoon of the 
same day, September 9, set the police to turn people off 
the vessel, and keep everybody from going on board her. 
The unloading was stopped, and the hatches shut down, 
but not before some thirty tons of ore had been taken out 
and placed in the Cobre yard. Measures of purifying the 
ship were now had recourse to; these continued until 
September 12, and consisted in washing the decks and 
forecastle with solution of chloride of lime, and in the 
copious sprinklings of chloride in the forecastle, steerage, 
hold, and places of storage. 

A man named Norman, whose case is recorded by Dr, 
Buchanan, noticed when he was on the ship on the 9th, 
before any chemicals were used, that a very bad odor 
came from the forecastle, where the sick people had been; 
and on Monday (the 11th), Dr. Paddon observed even 
the scupper holes filled with what appeared to be excre- 
ment, and had them cleaned out. The fumigation of the 
ship was finished on the 12th; the police were then re- 
moved, and communication with the vessel permitted. 



I 



438 HISTORY or yellow Fr*'tR. 

On the mornmg of the loth, she began to discharge her 
cargo, and fijiished unloading on the 20th or 21st of Sep- 
tember, lying all the time alongside the Cobre company's 
yard into which her ore was taken. The agent for the 
C'jlae company had this ore sprinkled with disinfecting 
fltLid. 

Medical Histokt of the ^^Hbcla.^ Pbevious to Her Ae- 
bttal at swaxsea. 

On the afternoon of the day when the Heel a arrived, as 
goon as action had been taken, inquiry into the history of 
the ressel and into the circumstances of her arrival was 
more accurately made. At about 3 P. M., the collector 
of ensoms instmcted the examining officer to pnt to the 
master the nsnal qnarantine questions. It must be pre- 
mised that the master had been guilty of an infraction of 
the quarantine laws, and that his answers were defensive 
in character, and were not always consistent with them- 
selves. From them it appears that the Hecla left Swan- 
sea on May 1. and touched at no place until she arrived 
at Cuba ; that she left Cuba on the 26th of July with a 
clean bill of health, again touching at no place in the 
homeward voyage. The master's answers further state 
that he was not aware of any infectious disease prevailing 
in any degree at the place from which he sailed, but that 
he heard reports of sickness at Cuba. He states that two 
seamen died at Cuba. (In a subsequent examination by 
Mr. Cullum, of the customs, the master stated that before 
sailing from Cuba several cases of sickness occurred, and 
on July 21. George Wilson died in the hospital on shore, 
and Hansel Pederson was left in the hospital sick). 
The master further stated that he had four officers, ten 
seamen, and two passengers on board (they had, however, 
dispersed at the time the examination was taken), and 
that in the course of his homeward voyage he lost three of 
those on board, viz., on August 11, one man, sixteen days 
sick; on August 21. a second, three days sick; and on Sep- 



SWANSEA, WALES 1865. 439 

tember 1, a third, forty-two days sick. The bedding and 
pillows of these men were thrown overboard. i 

Saunders, who died on the day of the HecWs arrival at 
Swansea, had been fourteen days sick. Of the six deaths, 
two had been from yellow fever, two from intermittent. 
(In his statement to Mr. Cullum the master says he con- 
sidered Saunders was suffering from dropsy. In the book 
of "receipts of wages and effects of deceased seamen," the 
cause of death of each of the six men is entered as "yellow 
fever.") Among other answers to the quarantine ques- 
tions, the master stated that all except the cases now men- 
tioned had been well during both voyages and at Cuba. 
(In his subsequent statement to Mr. Cullum, however, he 
says that several cases of sickness ccurred before sailing 
from Cuba, and that during the passage home several of 
the creAV, besides those who died, were sick). 

A Peculiar "Quarantine.^^ 

Those answers having been obtained from the master, 
the collector of customs forwarded them on September 9, 
to the Commissioners of Customs in London, and stated 
that "he had put the vessel in quarantine." On being 
questioned by Dr. Buchanan, on October 3, as to what 
this statement signified, inasmuch as the crew were al- 
ready dispersed, and the vessel partly unloaded, *the col- 
lector said that he meant that he had the quarantine 
questions put, and that the mayor had prevented com- 
munication with the ship, and had had her hatches shut; 
but that the customs authorities had adopted no pre- 
ventive measures. 

Ignorance of the Law Is Sometimes an Excuse. 

Dr. Paddon was desirous, on September 9, that the 
Board of Trade should be at once acquainted with the 
circumstances by telegraph, and their instructions asked. 
Finding this was not done, he wrote on September 11 to 



440 HISTORY OF YELLOW FEVER. 

the president of the Board of Trade, detailing the chief 
points already abstracted here. 

On September 15 the Board of Customs instructed Mr. 
Cullum, their collector at Newport, to proceed without 
delay to Swansea, and to institute a ful linquiry into the 
circumstances connected with the Hecla. The chief points 
elicited in this inquiry have already been stated. 

The observations of the Board of Customs upon Mr. 
Cullum's report are, "that there has been great irregu- 
larity and neglect of the usual precautions on the part 
of all persons on board, and that the master, the Swansea 
pilot, as well as the Bristol pilot, and the crew who landed 
from the vessel have in strictness rendered themselves 
liable to prosecution under the quarantine laws. They 
would, however, appear to have acted in ignorance and 
not from any willful intention of violating the law." This 
opinion having been communicated to the Privy Council, 
the custom,s authorities were informed that the parties 
implicated must be warned of their liability to prosecu- 
tion, but that under the circumsances no prosecution 
would take place. 

This is one of the few instances on record where igno- 
rance of the law has proved a convenient loophole for the 
guilty to escape. And yet, we have always been led to 
believe from infancy that the majesty of the law is 
supreme in Britain,a delusion which Dr. Buchanan's re- 
port punctures beyond re-inflation. 

The Epidemic. 

After Saunder's interment, and after the precautions 
before described had been taken, no further alarm appears 
to have been felt about yellow fever. The Hecla some 
days after unloading, was transferred from her place by 
the Cobre Wharf into the Beaufort Dock, a branch of the 
North Dock, surrounded by high warehouses. But on 
• September 23, the registrar of births and deaths in Swan- 
sea, got a medical certificate that a death had occurred 
from yellow fever, and heard it reported that other cases 
were about the town. That letter, transmitted by the 



SWANSEA, WALES 1865. 441 

Eegistrar General of births and deaths to the Privy Coun- 
cil Oilice, was the immediate cause of the inquiry headed 
by Dr. Buchanan being set on foot. This eminent scient- 
ist discGYcred that since the arrival of the Hecla, cases of 
true yellow fever had occurred among residents of Swan- 
sea. The character and sequence of the attacks were only 
made out by degrees; each is related separately with as 
much accuracy as possible in the supplement to the ex- 
haustive report from which this account is taken. The 
history of these cases, while exceedingly interesting, pre- 
sents the same clinical and pathological features which 
are seen in the average case of yellow fever, and not to 
make this chapter too lengthy, are omitted here. 

Dr. Buchanan calls attention to the fact that during 
the summer of 1865, and at the time of this -outbreak, 
there had been extremely little fever of any sort m swan- 
sea. What did exist was ordinary typhiod, and there 
were no cases of this on the island. There was not, and 
there had not been for many years, any instance of relaps- 
ing fever. 

^Between September 15, when the first case occurred, 
to October 13, when the last case became convalescent, 
there were twenty-two cases in which the diagnosis of 
yellow fever could pretty certainly be miade, and seven 
other cases in which the circumstances of exposure or the 
character of the attack led to a more or less strong suspi- 
cion that the illness was of the same nature. 

Of the cases diagnosed yellow fever, fifteen died — be- 
sides the man brought by the Hecla — and seven recovered. 
Of the doubtful cases, one died, and six recovered. 

Interesting Points of the Epidemic. 

Other ships having arrived at Swansea from infected 
localities in 1865, it appeared right, before connecting the 
Hecla with the deaths which occurred after her arrival, 
to make quite sure that no other vessels which had entered 
the harbor of the English port, coming from an American 
or West Indian port, had had any cases of yellow fever — 



442 HISTORY OF YELLOW FEVER. 

even not fatal — on board. In answer to an inquiry on 
this score, the Eegistrar General of Seamen furnished 
Dr. Buchanan extracts from the logs of all vessels so 
arriving within two months preceding the Hecla incident. 
These extracts showed that of the twentj-four "ships com- 
ing from Cuban waters which discharged their crews at 
Swansea during the year in question, onlv three gave 
histories of deaths from yellow fever, viz. : The Augusta 
Schneider^ one; the Victoria, two at sea; and the Hecla ^ 
whose history is given in these pages. 

IThis information, coming from such high authority, led 
Dr. Buchanan to the conclusion that no other vessel than 
the Hecla could be connected with the outbreak — an opin- 
ion which is no doubt shared by all those who have fol- 
lowed the history of this remarkable epidemic. 

The rise and progress of this epidemic shows that all 
those attacked either went on board the Hecla or visited 
the homes of the stricken ones. This proves beyond ques- 
tion that a small colony of yellow fever mosquitoes was 
imported to Swansea either by the ship in question or by 
other ships coming from the natural habitat of the in- 
sects. To the fact that the winged pests were not present 
in large numbers, is due the escape of the balance of the 
population of the thriving seaport from a disastrous visi- 
tation of the West Indian pestilence. 

Many interesting incidents are bro.ught to light in Dr. 
Buchanan's report. For example, the sloop, Eleonore, 
which remained about three days alongside the Hecla, 
discharging her cargo, 'left Swansea for a neighboring port 
(Ll.'^nely, q. v.), where she lost two of a crew of four, one 
of them certainly from yellow fever. 

Another remarkable fact is that the Bristol and Swan- 
sea pilots, the five seamen who helped to bring the ship 
into the harbor, the custom-house officers and men, and 
almost all the men employed in discharging the Heckrs 
cargo, escaped an attack of the fever (the after-history of 
most of them being known), although they had much more 
direct dealing with the ship than the persons who were 
attacked. For this circumstance, Dr. Buchanan states 



WOOLWICH, ENGLAND 1846. 44$ 

that no explanation can be offered. In this age of ad- 
vanced scientific knowledge, however, it is easy to account 
for this apparently extraordinary immunity. It can be 
explained in a few plain words : They were not bitten by 
the active agent of infection, the nefarious Stegomyia 
calopus. But lohy they were not bitten while others, less 
exposed, were, requires a modern Edipus to elucidate. 
We are modern, but we have no Edipian faculties. 

' WOOLWICH. 

1846. 

The Eclair is accused of having infected Woolwich 
in 1846. After the incident of 1845, the vesel was brought 
to that port, where it was thoroughly renovated and, to 
miake the metamorphosis more complete, the name Eclair 
was stricken from the marine register and the rehabili- 
tated vessel christened Rosamond. But the infection was 
still dormant in the hold and broke out while the ship 
was being put in trim for a voyage to the South Atlantic 
stations. Four men were attacked with what the Second 
Report on Quarantined^ is pleased to be called "typhus,'' 
but which was no doubt yellow fever. Two of the patients 
died in the Woolwich hospital. What gives additional 
color to the assumption that the disease was yellow fever, 
is the fact that in February, 1847, three days after leaving 
Woolwich, another "suspicious" case was observed, fol- 
lowed in rapid succession by others as the vessel neared 
the tropics. When in the neighborhood of the Cape Verd 
Islands, before any communication was had with the shore, 
a sailor died on board, having vomited black for two 
days, after having shown other marked characteristics of 
yellow fever infection. We can therefore safely assert 
that the outbreak at Woolwich, while the ship was being 
renovated, was a typical manifestation of yellow fever. 

** Second Report on Quarantine, 1852, p. 98. 



4-14 HISTORY OF YELLOW FE.\ER. 

1S4S. 

The war- steamer Gr order infected Woolwich in a round- 
about war in 1SJ:S. The vessel, which was employed in 
conveTing liberated Africans to the West Indies, left 
Sierra Leone on November 12. 1S47. and arrired at Trini- 
dad on December 5. Duidng the Tovage. forty-six deaths 
occurred among the emigrants from dvsenterT and two 
from "'feTer.'' The total number of cases of ^'fever" under 
treatment was seTentv-five. of which seventv-two recov- 
ered. After visiting other West Indian Islands and being 
accused of infecting Barbadoes. the Growler rettirned to 
Africa, whence she sailed for Woolwich. When the 
hatches were opened at that port, two men wlio slept 
directlv over the hatchway, were afterwards seized with 
fever, possessing all the characteristics of yellow fever 
and. in the course of a few days, both had black vomit and 
died in the Marine Infirmary.-"^ The fact that they slept 
near the open hatchway made them an easy prey to the 
infected mosquitoes which were lurking in the shijj's hold. 
The disease did not spread to the town. 

^Brvson: Climate and Diseases of the African Stations, p. 
224; also Milroy: Lancet, London, 1853, vol. 1, p. 461. 



HISTORY 



OF 



YELLOW FEVER 



IN 



ITALY. 



I 



ITALY. 

Italy is the easternmost country in Europe where yel- 
low fever has been observed. Only on two occasions, 
however, has the disease made any progress on its shores — 
Leghorn, in 1804, and Torre Annuziata, in 1883. The 
only epidemic of any consequence was that of Leghorn. 



CHKONOLOGY OF YELLOW FEVER IN ITALY. 



1804. 


Leghorn; Pisa. 


1821. 


Leghorn. 


1828. 


Leghorn. 


1850. 


Genoa. 


1868. 


Naples. 


1870. 


Varignana. 


1883. 


Torre Annunziata. 




By Localities. 



Genoa. 1850. 

Leghorn. 1804 ; 1821 ; 1828. 

Naples. 1868. 

Pisa. 1804. 

Torre Annunziata. 1883. 

Varignana. 1870. 

•GENOA. 

» 

Description. 

Genoa is a seaport of Northern Italy, on the coast of 
the Mediterranean, at the head of the Gulf of Genoa, 
seventy-five miles southeast ofl Turin. It is one of the 
oldest cities of Europe, its origin being said to be more 
remote than that of Rome. Its population in 1883 was 
about 140,000 ; in 1903, 222,000. 



448 HISTORY OF YELLOW FEVER. 



Yellow Feteb Yeaes. 



1S50;1903. ; 

SUMMAKY OF IMPORTATIONS. 

1850. 

A ressel from Pernambuco, Brazil, is accused of bring- 
ing TelloTT fever to Genoa in 1850. ^o details are givejn 
by our authority.^ - 

1903. 

The health authorities of Genoa were put on the qui 
vive in April, 1903, by the report that the steaimer 
Afrtonina, from Buenos Ayres, which arrived at the Ital- 
ian port on April 23, was infected with yellow feyer.'- 
An inyestigation revealed the fact that a '^'suspicious 
death'^ had occurred during the voyage. As the Antonina 
carried 713 passengers destined for Genoa and contiguous 
ports, precatitionary measures were immediately taken to 
prevent a spread of the disease. Xo cases erupted while 
the vessel was at Genoa. 

LEGHOEX.' 
Description. 

Leghorn is an important seaport of Western Italy, on 
the Mediteranean, twelve miles southwest of Pisa and 
sixty-two miles west of Florence. Leghorn was a mere 
fishing village in 1121. when it fell into the hands of the 
Florentines, and it contintied tO' be a. place of small im- 
portance till the 16th Centtiry, when the decline of Pisa 
as a commercial mart gradually gave it prominence until 
it now ranks third among the chief ports of Italy, being 
excelled only by Naples and Genoa. 

^ Berenger-Feraud : Traite Theorique et Pratique de la Fierre 
Jaune (Paris, 1890), p. 120. 
= U. S. Public Health Reports, 1903, vol. 15, p. 852. 



LEGHORN. 449 

. Yellow Fevee Years. 

1804; 1821; 1828. 

Summary of Epidemics. 

1801. 

Keating^ claims that yellow fever was present at Leg- 
horn in 1801, and that ^^150 died daily for several months." 
A search through thei works of Palloni,^ Tomassini,^ 
Dessessartz and Halle,^ Guillaume and Gouet/ Ozanam,^ 
Berenger-Feraud,^ Mocchi, Pasquetti and Brynole,^" 
Guignon/^ and others who have written at length upon 
the prevalence of the disease at Leghorn, fails to verify 
Keating's statement. The learned gentlemen evidently 
got his dates mixed or inadvertently substituted Leghorn 
for some other locality. 

1804. 

The epidemic of yellow fever which almost devastated 

Leghorn in 1804 was for a long time the subject of much 

. . — — . __ — . — _ — — 

'Keating: History of Yellow Fever, 1879, p. 81. 

*Palloni: Observatione Mediche Sulla Malattia Febrile Domin- 

ante in Livorno. Livorno, 1804. 
'Tomassini: Recherclies Pathologiques sur la Fievre Jaune, 

Paris, 1812. 
•Dessessartz et Halle: Jl. Gen. de Med., Cbir, et Pbarm., Paris, 

1805, vol. 23, pp. 3; 19. 
'Guillaume et Gouet: Jl. de Med., Chir. et Pharm., Paris, 

1805, vol. 23, pp. 274; 331. 
"Ozanam: Histoire Generale, Medicale et Particuliere dea 

Maladies Epidemiques, 1835, vol. 3. 
» Berenger^Feraud : Loc. cit. 
*" Mocchi, Pasquetti and Drynole: iRelazione Medica della 

Malattia cho Domina Presentimente in Livorno. Livorno, 

1812. 
"Guignon: Dissertation sur la Fievre Jaune qui a Regne a 

Livourne en 1804. Paris, 1810. 



450 HISTORY OF YELLOW FEVEER. 

heated discussion as to diagnosis and source of infection. 
Bally^^ incriminates a Jew from Gibraltar, who surrepti- 
tiously entered the city; other authors contend that the 
disease was of home origin, while some place the onus 
on America. The most plausible and generally accepted 
opinion, however, is the one expounded by Ozanam,^^ who 
implicates the Anna Maria in the importation. The facts 
are as follows: 

A Spanish ship, the Anna Maria, entered the pJort of 
Leghorn, August 18, 1804. On a voyage from Havana 
to Cadiz this vessel had lost the entire crew from yellow 
fever. At Cadiz the ship was refused permission to enter 
port, but was allowed tO' recruit the crew in quarantine. 
Through some irregularity the Anna Maria was given 
clean papers at Cadiz and, July 10, passed Gibraltar and 
proceeded to Alicante, where she received free pratique. 
The vessel sailed fro'm Alicante August 9, and reached 
Leghorn August 18. Owing to the prevalence of yellow 
fever in Spain, special sanitary restrictions had, since 
July 17, been placed on all vessels arriving at Leghorn 
froim Spanish ports. There had been sickness on board 
the Anna Maria on the passage from Alicante to Leghorn. 
The declaration of the captain, supported by oath, and 
the liberal donations of money made by the owner of the 
cargo, appear to have been effective in quieting all appre- 
hensions at Leghorn.^^ The ship was given free pratique. 
Two sick men taken from aboard were carried ashore and 
lodged at an inn in the Strada Pescheria Yecchia. These 
men died three days after, and a few days later twelve 
persons at the inn were taken sick. All the cases ended 
fatally. A Neapolitan who had left the inn at the first 

"Bally: Typhus d'Amerique (Paris, 1814), p. 91. 

"Ozanam: Historire Medicale, Generale et ■ Particuliere des 
Maladies Epidemiques (Paris, 1835), vol. 3, p. 227. 

"This incident goes to prove that "graft" is not a strictly 
modern American institution, but has done much to 
shape the destiny of the world since the day 
Mephistopheles handed Adam that delicious apple in the 
Garden of Eden. — ^G. A. 



LEGHORN 1804. 451 

appearance of the disease was attacked ten days after and 
died in another neighborhood. A French butcher who 
took breakfast at the inn in the Strada Pescheria Vecchia 
died of the disease in ten days. Soopq after his wife, the 
woman who owned the house in which he lived, and a 
friend, an officer of the French army, died of the same 
affection. At the time these events were occuring at the 
inn, another focus was formed at a bakery in the Via 
San Antonio. A baker had brought from the infected 
ship a quantity of sacks which were to be filled with 
biscuits. The bread was baked in the night and, in the 
intervals between ovenfuls, the bakers rested themselves 
by lying down on the empty bags, iln a few days these 
men were stricken with a strange malady. Suspicion 
was directed against the Anna Maria as the source of the 
disease, and sanitary guards were stationed aboard. In 
their turn, the guards acquired the disease, 
and wood used in the art of dyeing, and was stored in 
warehouses in different part 0{f the city. In the neigh- 

The cargo of the Anna Maria consisted of sugar, hides 
borhood of these magazines the disease gained quick head- 
way. The porters who handled the goods and the cus- 
todians of the warehouses were taken with the disease. 
Two poirters and one custodian died. Thus, spreading by 
degrees, the malady extended throughout the city of Leg- 
horn. At that period Leghorn had a population of 60,666, 
not including the men of the French garrison. Abofat 
7000 fled. The French soldiers were transferred else- 
"where. None of those who left the city carried the dis- 
ease to the places they fled to, with the exception of two 
refugees who died at Pisa ( q. v. ) 

Authorities widely differ as to the total mortality. 
Lacoste says that 1,900 died during siege of the fever, 
Lacoste^^ says that 1,900 died during siege of the fever, 

"Lacoste: Dissertation Historique sur la Fievre Regnante a 

Llvourne, etc. Livourne, 1804. 
**?Coppi: Cenni Storici di Alcunne Pestilenze. Roma, 1832. 
"Bally: Typhus d'Amerique, p. 81. 
■■Pallonl: Loc. cit. 



454 HISTORY OF It-ELLOW FEVER. 

last named figures are those generally accepted. A'ccord- 
ing to Palloni's computation, the deaths were as Mlows : 

August 7 

September 51 

October 204 

November 390 

December 3 

I Total 655 

The fever was at its height in the beginning of Novem- 
ber, gradually declined after the 15th of the month, and 
had totally disappeared by December 9th. 

1821. 

Cornilliac^^ claims that yellow fever was present in the 
shipping at Leghorn in 1821. 



1828. 

According to Cornilliac,^^ a vessel brought yellow fever 
to Leghorn in 1828. There was no spread of the disease. 



NAPLES. 



Description, 

Naples is the most populohis city of Italy. It is situ- 
ated on the shores of the Adriatic, on the Bay of Naples, 
at the foot of Mount Vesuvius, 118 miles southeast of 
Rome. 



"Cornilliac: Recherches Chronologiques, etc., (Fort-de- 

Franoe, Martinique, 1886), p. 228. 
«*Cornilliac: Loc. cit, p. 228. 



ITALY. 453 

1868. 

Profilo^^ relates an interesting case, said to be yellow 
fever, which was observed in Naples in 1868. \ The 
patient, a gunsmith, aged 40 years, came to Naples from 
Torre Annunziata. The onset of the attack occurred on 
February 10, and he was admitted to the Hospital in the 
clinical ward of Prof. Cardarelli on the eighth day of the 
disease, February 18. At that time, his skin and visible 
membranes were of a decided yellow color. Albumin 
was present in the urine. Under careful treatment, his 
condition improved and about two weeks later he left 
the hospital to return to his ho^e in the Province of 
Parma. 

A carelhil search through Profilo's article fails to dis- 
close the source of infection in this case. In his synop- 
sis of the symptomatology, the learned gentleman says that 
the diagnosis was tifo icterodes hiliosa. We doubt very 
much, from a careful digest of the clinical history given by 
Dr. Profilo, that this was a case of yellow fever and for this 
reasoin do not include it in our chronology. We have 
given it a place in this volulne for the reason that it is 
the only instance where a case of yellow fever is said to 
have been observed in Naples. 

!PISA. 

Description, 

Pisa is a city of Northern Italy, capital of the province 
of the same na'me, six miles from the Mediterranean and 
forty-ffour miles west of Florence. It is located on both 
banks of ^he Arno, here crossed by three stone bridges 
for general traffic and one for the railway. In the north- 
west part of the city are the famous "Leaning Tower" 
and the Campo Santo, the most remarkable cemetery in 
the world. 

** Profilo: TJn Caso de Tifo Icterode. Morgan! (Napoli), 1868, 
vol. 10, p. 897. 



454 HISTORY OF YELLOW FEVER. 

Yellow Feveb Yeab. 
1S04. 

SUMMAEY OF IMPORTATION. 

During the preTalence of the great epidemic of yellow 
fever at Leghorn in 1804, 7,000 of its terror-stricken in- 
habitants fled to the snrrounding country. Of this vast 
number, only two can?ied the infection with them.^'^' 
These two were stricken sick after their arrival at Pisa 
and died with black vomit a few days after the onset of 
the attack. The population of Pisa was thrown into con- 
sternation and the refugees made preparations to flee 
anew. The authorities, to stem the threatenei panic, 
publicly burned the belongings of the dead, proclaiming 
that such a course would prevent the ••contagion"' from 
spreading. So other cases erupting, confidence was re- 
stored and to this day the good people of Pisa, no doubt, 
attribute their escape from a visitation of the terrible 
pestilence to the incineration of the clothes and bedding 
of the two victims of the scourge. 

TOREE AXXUXZIATA. 

Description. 

Torre Annunziata is a seaport in the Province of 
Naples, Italy, at the foot of Vesuvius, on the Bay of 
Naples. 

Yellow Fever Year. 
1883. 

Summary of Epidemic. 

The second epidemic of yellow fever on Italian soil 
took place at Torre Annunziata in 1SS3. nearly eighty 
years after the "Great Epidemic" of 1S04. The terror 
which this visitation of the Saffron Scourge would have 

^ Dictionaire des Sciences Medicale (Paris), vol. 15, p. 356. 



TORRE ANNUNZIATA 188S. 455 

otherwise caused, was totally overshadowed by the greater 
epidemic of cholera which threatenM to overrun Italy that 
year and which created such havoc in Naples the following 
year. 

According to researches made by Eager^^, the first case 
occurred June 19, 1883, in the person of a tavern keeper, 
aged 60, from Ischia. This man went directly from 
Ischia to Torre Annunziata, May 29, to transact business 
as a wine merchant. His case was diagnosed as one of 
grave icterus and he died July 8, in Via Cisterna. A 
few days later another man, 80 years old, living in the 
Via del Popolo, two or three blocks away, died with the 
same symptoms. The attending physicians made a diag- 
nosis of acute yellow atrophy of the liver. The third 
ease was that of a woman aged 70 years, who died August 
25, after an illness of eight days. She lived in Via Gari- 
baldi, within two blocks of the first cases. The same 
diagnosis of acute yellow atrophy was made. 

Early in September, several persons living in Via Cis- 
terna were taken sick about the same time and with the 
same symptom.'s. An alarm arose and strict sanitary 
measures were employed. September 6, a custom-house 
clerk in Via Cisterna was taken ill. He had a chill, pains 
in the back, high fever, slow pulse, severe headache and 
black vomit. He died in seven days. Cases continued 
to appear in the same neighborhood until October 13. 
There were in all thirteen cases and seven deaths. In 
September, a commission of medical men from the Uni- 
versity of Naples investigated the disease. Among them 
was Professor Somma, who died in the cholera epidemic 
at Naples the next year. Afiter much discussion the 
members of the commission admitted the specific nature 
of the malady, but did not give it a name. However, 
Professor Somma, in a concise letter written September 
24, 1883, to Dr. Gennaro Cozzolino, made the statement 
that the disease prevailing at Torre Annunziata was yel- 
low fever. During the height of the epidemic the most 



Eager: Bull. No. 8, Yellow Fever Institute, 1902 ,p. 31 



456 HISTORY OF YELLOW FEVER. 

careful investigations were made; necropsies were con- 
ducted by the most skillful pathologists of Naples ; a 
special lazaretto was established, and the most stringent 
measures of isolation and disinfection insisted upon. The 
disputes betweeuv medical men were numerous and more 
or less violent. As a result, the consensus of opinion ex- 
cluded yellow fever. Icteroid typhus and infective fever 
characterized by jaundice were the diagnosis settled upon 
by the different physicians who went so far as to give it 
a name. 

VERIGNANA. 

Description, 

We have been unable to locate the exact position of 
Verignana on the map of Italy, but infer from Allan's 
article that it is a small place between Leghorn and 
Genoa. 

Yellow Fever Year. 
1870. 

Summary of Importation. 

According to Allau,^^ two cases of yellow fever were 
observed in the lazaretto at Verignana in 1870. The 
facts, as translated from Allan's article, are as follows : 

The merchant vessels Guise ppe and Pirro, both from 
Leghorn, went on a cruise to Barcelona, Spain, where 
several of the crew were infected with yellow fever. 

The Guiseppe left five sailors in the hospital at Bar- 
celona and three more contracted the disease on the home- 
ward voyage. Of the latter, two died and were buried at 
sea. ' 

The Pirro left five sailors in the hospital at Barcelona; 
an additional case followed by death, developed on the 
voyage from Barcelona to Leghorn. 

The authorities of Leghorn, recalling the epidemic of 

**Allu: Relazione Finale sui Casi di Febre Gialla Verificatisi 
nel Lazaretto de Varignano durante TAutumno 1870. 
Venizio, 1871. 



ITALY. 457 

1804, which was bromght ot the town in just such a man- 
ner, refused to allow the vessels to enter the harbor. The 
infdcted ships then went to Verignana, where an attempt 
was made to conceal the fact that yellow feyer had oc- 
curred on board. The authorities were suspicious, how- 
ever, and the Guiseppe and Pirro were detained at quar- 
antine and put under surveillance. Two health officers 
of the village, detailed on board the vessels, were stricken 
with yellow fever, one on October 6, dying on October 8, 
ajid the other October 7, dying on the 12th. 

No other cases erupting, quarantine was raised 
November 10. 

CONCLUSIONS. 

The epidemic at Torre Annunziata is the last observed 
on Italian soil. Since 1883, vessels have come to the sea- 
ports of the kingdom with histories of deaths from yellow 
fever during the voyage, but no case has erupted on 
shore since 1883. And, with our present knowledge of 
the mode of transmission of the disease under discussion, 
we fervently hope none ever will. 



YELLOW FEVER 



IN 



PORTUGAL. 



PORTUGAL. 

With the exception of Lisbon, which has suffered much 
from occasional visitations of yellow fever, the history 
of the disease in Portugal is of minor epidemiological 
interest, being confined to seven localities, from 1718 to 
18S0. The only epidemic of consequence was that of 1857, 
which threatened to invade the entire kingdom and caused 
a mortality of 5,652, in Lisbon. 

Chronology of Yellow Ffv'er in Portugal. 

1718. Peniche. 

1721. Ericeira. 

1723. Lisbon (Great Epidemic). 

1724. Lisbon. 

1850. Oporto. 

1851. Oporto. 

1856. Belem; Lisbon; Oporto. 

1857. Belem; Bom Successo; Lisbon (Gre-at Epi- 
demic) ; Olivaes. 

1858. Lisbon; Oporto. 
1860. Lisbon Cin harbor). 

1879. Lanceda ; Lisbon. 

1880. Lisbon (in harbor). 

By Localities. 
Belem. 1856; 1857. 
Bom Successo. 1S57. 
Ericeira. -1721. 

Lisbon. 1723; 1721; 1856; 1S57; 1S5S; 1S60; 1879; 
1880. 

Olivaes. 1857. 

Oporto. 1850; 1851; 1856; 1858. . 

Peniche. 1718. 

BELEM. 

Description. 

Belem is a town of Portugal, three miles south of Lis- 
bon, on the right bank and near the mouth of the Tagus. 
It has been a part of Lisbon since 1885. 



1856; 1857. 



BELEM 1956, 

Yellow Fevee Years. 

Summary of Epidemics. 
1856. 



461 



Guyon,^ Eager^ and Berenger-Feraud^ give interesting 
accounts of the epidemic of 1856, the first on record at 
Belem. This port was the seat of the yellow fever hos- 
pital during the epidemic at Oporto. The first case at 
Belem was observed in A*ugust, in the person of the wife 
of a druggist of the town. This case was followed by two 
others in the same family, and then by scattered cases 
at considerable interval and, finally, an epidemic estab- 
lished itself. The fever was mistaken for typhus by the 
local physicians, but the miembers of the Eoyal Commis- 
sion that investigated the pestilence found that at least 
some of the cases presented the undoubted characteristics 
of yellow fever. There were 100 cases and 30 deaths. 

Lisbon is suspected of having infected Belem. 

1857. 

In 1857, occurred the great epidemic of yellow fever 
at Lisbon (q. v.) The disease was transmitted from Lis- 
bon to Belem by a carpenter who made daily trips be- 
tween the two cities. He was taken ill October 12. His 
wife was stricken on October 14 and died on the 20th. 
The carpenter was transported to his mother's house. 
The father contracted the disease and died on the 28th.^ 
This was the last death of the outbreak. 



*Guyoii: Gazette Medicale de Paris, 1858, vol. 39, p, 451. 
•Eager: Bull. No. 4, Yellow Fever Inst, Washington, 1902, p. 

10. 
•Berenger-Feraud: Fievre Jaune, etc., (Paris, 1890), p. 127. 
* Berenger-Feraud, p. 131. 



462 HISTORY OF YELLOW FEVIR. 

BOM SUCCESSO. 
1857. 

In 1857, during the progress of the epidemic Trhich 
"was ravaging the coast cities of Portugal, the infection 
Tras brought from Lisbon to Bom Successo, a Tillage near 
the capital, by a child Tvho had slept in a house where 
cases had occurred. On Xovember 11, the day after its 
arrival, the child was attacked by the fever and died on 
the 19th. The boy's father, who had been constantly at 
the little patient's bedside, fell a victim to the pest.^ We 
find no record of other cases at Bom Successo. 

EKICEIKA. 



Description. 

^Ericeira is a town of Portugal, near the Atlantic, 
twenty-two miles northwest of Lisbon. Population, 2,091, 
mostly fishermen. 



1721. 



Ericeira occupies the doubtful honor of being the sec- 
ond place in Portugal where yellow fever has been ob- 
served. According to Guyon,^ who gives Kodrigues de 
'Avreu as his authority, the disease was imported to the 
town in 1721. Xo details are given. 



• Berenger-Feraud, p. 131. 
•Guyon: Loc. cit. 



40S 

LISBON. 

Description. 

Lisbon, capital of the Kingdom of Portugal, is on the 
right bank of the Tagus, near its mouth in the Atlantic 
Ocean. The climate is healthy, but variable, the city 
being exposed to heavy rains and cold winds in winter. 
Population, 1864, 208,376; 1878, 253,496. In 1885, Belem 
and Olivaes were made part of the city. j 

Historical Resume, 

Lisbon is a place of remote antiquity. It was anciently 
called Olisipo or Ulyssippo, on account of its foundation 
being ascribed to Ulysses. It was originally a Koman 
profvince, but wa:s conquered by the Goths, from whom it 
was captured by the Moors in 716. The new conquerors 
called the city El-Oshbuna and retained poossession of it 
until 1147, when it was seized by Alphonse I, of Portugal, 
with the aid of the English, French and Flemish cru- 
saders. In 1713, it was attacked and partly burned by 
the Castillians, but the inhabitants succeeded in repuls- 
ing the invaders. The Castillians again made an unsuc- 
cessful effort to capture the city in 1724. It was made 
the capital of the Kingdom by Juan I in 1422, and was 
seized in 1580 by Alva for Philip II of Spain. It was 
from this port that the famous ^'invincible" 'Armada 
sailed in 1588. In 1640, the Duke of Braganza aroused 
his countrymen to shake off the Spanish yoke and once 
more Lisbon became the capital of Portugal. 

The French were in possession of the city for ten 
months during 1807-08. A series of military revolts in 
the middle of the last century culminated in almost open 
rebellion in 1831, which was with difficulty put down by 
the government. ; 

Lisbon suffered from a severe earthquake in 1344, was 
devastated by the plague in 1348 and was almost de- 
stroyed by the "Great Earthquake'' of 1755, which, in ten 



464 



HISTORY OF YELLOW FZVER. 



minutes, killed between 40,000 and 60,000 people and 
damaged propertT to the extent of $100,000,000. 

The tale of Lisbon's misfortunes, coveping a period of 
over twelve centuries, was culminated on February 1, 
1908, bv the assassination of King Cai^los I and the Crown 
Prince bv anarchists in the streets of the ancient metro- 
polis of Lusitania. 

In addition t<> the turmoils of internal dissensions and 
inroads by the Moors, Lisbon has been repeatedly visited 
by epidemics from an early period. The following table 
gives a tolerably correct summary of the many eruptions 
of pestilential disease in the Portugese c-apital. 

Cheoxology of Epidemics at Lisbon Singe 1191. 



Year. NATURE OF DISEASE. MONTH 



DURATION 



MORTALITY 



1191 Epidemic Meninffitis 

134> Black Death 

1S*4 Contaeious Typhus 

1415 Pla^je _ 

1437 Plagrae 

14S* 'Pestueiitial Epidemic"— 

14o4 Plague 

14o^ Pia^ae ; 

1470 Plasrue _ 

U:<4 Plazue- - 

1437 Military Sweat -- 

1403 Plag-ue 

15<33 Plague - 

15;i5 Epidemic Petechial Fever 

1510 Plague 

1514 Military Sweat ~ 

1517 Plaffue 

1533 PlagTie _ i 

1522 PlagTie 

152o Plagne — — 

1531 Plagrue - 

1557 Whoop inff Coujh- 

l5o« Plajrue — 

l5i5 Tvohns -- - - 

157C' PLa^^e 

159S Plagrue -- 

160i3 Piaarue 

1631 Contaarious Typhus 

lt>41 "Typhosoi Prisons" 

lo5.S "Typhus of Camps" - 

167-'^ Piarae ™ 

172 3 Yellow Fever .. 

1724 Yellow Fever 

1755 Tvphoid Fever _ 

ISIO "Typhus of Camps" 

1»32 Cholera ~- 

l*5c Chftlera 

1856 Yellow Fever --_ 

185 7 Yellow Fever 

1858 Yellow Fever - 

1860 Yellow Fever _ 

18 79 Yellow Fever 

1880 Yellow Fever 



January 

September 29. 
AufiTust 1—- .- 

June 

No Record 

March — 

October 

No Record — 

Ausmst 

October 

February 

No Record 

October 

July 

No Record 



- 3 Months 

. 3 Months - 

. 1 Month and 3 Days 

-No Record - - 

-eTwo Years - 

-liFour Month* 

• No Record 

'Two Tears 

- 1 Year and 2 Month? 
No Record - 

. 2 Years and 7 Months 
2 Years and "Months 
2 Years- - 

- 2 Months 

.; No Record — 



April-- [3 Months 

No Record-. 9 Months 

August No Record 

No Record ! ** — 

June — — 5 Months — 

April 3 Months - 

November 10—1 Year and 4 Months 

October 26- 10 Months 

No Record August, lo02 — - 

May — No Record- 

December 

No Record " 

December " 

Sept. 15 3 Months 

Aufirust 2 Montlia 

November 4 Months 

October 10 Months — 

No Record No Record 

Aueust September 

September .. December 

Jantiary February 

Kay — May — 

May - Two Cases 

Juae 10 One Case — 



No Record 

20.e<>J. 'Pop. 60,000) 
No Record 

'I 

80.000 .""..!."" 

No Record 

40.iX)0 

No Record 

6.o«o Pop. iso.ftior 

No Record 

i '- E:;;;;; 

3. 600 

40 ~ 

5,65» 

Small - 

Two .-~'r.r.*-r.i*™ 

None ..- " 



LISBON — 1723. 465 

Yellow Fever Years. 

1723; 1724; 1856; 1857; 1858; 1860; 1879; 1880. 

Summary of Epidemics. 

1723. 

, The third invasion of Portugal by yellow fever took 
place at Lisbon in 1723, during the reign of Juan V.^ 

The documents relating to this outbreak are very rare 
and only meagre details could be obtained. According 
to Da Cunha,^ the first case was observed on September 
15. The epidemic lasted three months, causing a mor- 
tality of 6,000, out of a population of 250,000. Amo-ng 
the illustrious dead was the greait admiral, Antonio Este- 
vao de Costa Sousa. The last death took place in 
November. , ( 

Da Cunha designates the disease under the name o*f 
Vomito Pi^eto. It was evidently imported from the West 
Indies. Eager^^ claims that the disease was imported 
from Brazil, but as there is no record whatever of the 
prevalence of yellow fever in that country in the 
eighteenth century, we think it is more logical to incrimi- 
nate that natural hotbed of dissemination — the Antilles. 

1724. 

Yellow fever was again present in Lisbon in 1724. 
There were only a few cases and the mortality was not 
high. It is to be regretted that the authors who have 
written on this recrudescence of the disease in the capital 



'First recorded invasion took place at Ericeiva (q. v.) in 
1721. 

'Acunha: Discouro e Onservacoes Apollineas Sobre as 
Doencas que Houve na Cidade Lisboa Occidental ne 
Oriental no Otouno de 1723. Lisboa, 1726. 

^* Eager: Loc. cit, p. 9. 



466 HISTORY OF YELLOW FEYER. 

of Portugal (GuTon.^^ Avreu,^- Leitau,^^ Sachetti,^* 
Salndaha^^ and Berenger-Feraud^^) do not go into more 
aninute details. 

1856. 

For a period of one hundred and thirty-one years — 1724 
to 1S56 — no record can be found of the prevalence of yel- 
low fever in Lisbon. 

In 1856, the disease was epidemic at Oporto, which is 
170 miles north of Lisbon, and it is not surj^rising that it 
should have manifested itself in the capital that year. 
The first cases were observed at Belem, a subtirb of Lis- 
bon, towards the last days of August. Shortly after, 
cases cropped out here and there in Lisbon, but the mal- 
ady was not extensive, resulting in 211 cases and 40 
deaths.^" 

The original source of infection of this epidemic was 
Brazil, as will be seen by reference to our account of the 
fever which prevailed at Oporto in 1856. 

1857. 

The epidemic of 1857 was the most disastrous which 
had visited Lisbon since 1723 and gave rise to numerous 
elaborate and learned monographs and treatises on yel- 
low fever, prominent among which are the works of 

"GuTon: Gaz. Med. de Paris, 1S5S, p. 451. 

"Avreu: Loc. cit. 

^^Leitao: Medicina Comme Arte (1738). 

"Joa Mendes Sachetti: Consideracoes Medicas. 

^Salndaha: Illuatracao Medica, vol. 2, p. 4S3. 

" Berenger-Feraud : Loc. cit., p. 43. 

*• Lyons: Report of the Epidemic of Yellow Fever at Lisbon in 
1857, p. 113. (The figures given by Lyons are 311 cases 
and 11 deaths, but as 100 cases, followed by 30 deaths, 
were observed at Bel,em, then a seperate city from 
Lisbon, we have deducted these last figures from Dr. 
Lyons' total. — ^G. A.). 



LISBON — 1857. 467 

Pinto/^ Alvarega^^ and Lyons^^o ^j^^ ^j^^ Keport of the 
Extraordinary Council of Public Health of Lishon.^^ 
These monographs contain many odd and untenable doc- 
trines, it is true, but are, nevertheless, historically accur- 
ate and can be fructuously consulted by the student. 

Origin^ Rise and Progress of the Epidemic. 

Three vessels are accused of having brought yellow 
fever to Lisbon in 1857 — the Tamm% the Gerona and the 
Cuidad de Belem. These three pest ships came f!rom 
Brazil. 

In March, 1857, yellow fever developed on board the 
steamship Tamar^ from Eio de Janeiro, and when the 
vessel reached Lisbon, the captain reported having lost 
two men from the disease during the voyage. The vessel 
only touched at Portugese ports, leaving immediately for 
England. As will be seen by reference to our account of 
yellow fever at Southampton in 1857, that port was in- 
fected by the Tamar shortly after her arrival, thus prov- 



"De Sequeira Pinto (A. C.) : Relatorio Dirigido ao Governo de 
Sua Magestade acerca da Organisacao e ;Servico dos 
Hospitaes Provisorios de Febre Amarella Estabelecidos, 
em 1857, n'esta Capital e do Respectivo Movimento 
Clinico Desenvolvido por Quadros Estatisticos. Lisboa, 
1858. 
Also: Union Med., Pairis, 1863, 2. s., xvii, 570; 585.. 
By the same author: Parecer de Alguns Medicos Estrangeiros 
e Nacionaes Acerca da Anatomia Pathologica e Symp- 
tomatologia da Febre Amarella em Lisboa no Anno de 
1857. Lisboa, 1862. 

^° Lyons (R. D.): Report on the Pathology, Therapeuties, and 
General Aitiology of the Epidemic of Yellow Fever 
which Prevailed at Lisbon, during the Latter Half of the 
Year 1857. London, 1855. 

^ Relatorio da Epidemia de Febre Amarella em Lisboa no anno 
de 1857. Feito pelo Conselho Extraordinario de Saude 
Publica do Reino. — Lisbao, 1859. 



468 HISTORY OF YELLOW FEVER. 

ing that the Tessel was a hotbed of pestilence. Nothing 
unusual occurred to disturb the health conditions of 
Lisbon after the departure of the Tamar, and the inci- 
dent was soon forgotten by the authorities. The Tamar 
again touched at Lisbon in September, but no history of 
the disease baring prevailed on board at that time could 
be found. / 

According to the arailable documents and the accounts 
of the epidemic by the authors above named, notwith- 
standing the prevalence of laryngeal affections, bron- 
chitis, diseases of the lungs and rheumatism during the 
first three months of 1857, which were followed in the 
spring and early summer by erysipelas, typhoid, inter- 
mittent and remittent fevers, and also gastric maladies, 
the public health of Lisbon proved satisfactory until the 
end of July, as shown by this coniclusive fact, that the 
rate of mortality throughout the metropolis of Portugal 
actually ranged less than it had done during the analo- 
gous six months of the two previous years. 

Such was the sanitary condition of the Portugese cap- 
ital when the steamship Genora, from Eio de Janeiro, 
arrived at Lisbon early in July, 1857, bringing immi- 
graoQts from Brazil. Many of these persons were so ill 
that all of them were sent at once to Belem to pass the 
period of quarantine in tlie lazaretto. Cases began to 
erupt at Belem soon after the arrival of the Genora. The 
infection eventually reached Lisbon, where the first une- 
quivocal case of yellow fever developed in a man dwelling 
in Padaria Street. The patient died on the fifth day of 
the attack. A second case, affecting a woman, occurred 
on July 29, which likewise terminated fatally on the fifth 
day. The epidemic slowly spread to other districts, be- 
coming more prevalent during August and September, 
being especially severe during October, about the middle 
of which month the malady manifested its gTeatest in- 
tensity. 

It is a peculiar fact that while the fever was ravajrfng 
the city proper, the health of the harbor remained good. 
No cases are recorded as having occurred in the shipping 



LISBON — 18 37. 469 

during the progress of the epidemic and the health-guards 
stationed along the water front proved imniune to the 
pestilence. This anomalous state of things puzzled the 
Royal Commission to a considerable degree, and caused 
theml to propagate the dogma that the infection had 
not been introduced by vessels and their crews, but by 
*^filthy fomites deposited in the customs magazines of 
the town'' — an opinion which seemed plausible then, but 
which reads like a passage from the Arabian Nights at 
the present day. 

The spreading of the disease from one locality to an- 
other deserves special mention. Tlie Eeport of the Port- 
ugese Board ofl Health informs us that it travelled by 
slow and successive steps from place to place, generally 
from one street to another, and even from house to house, 
according to their proximity, and extending from lower 
to higher parts of the cit}^; where, however, the epidemic 
manifested minor intensity than throughout less elevated 
districts. This progress seemed so regular, that observers 
could almost tell beforehand the course which the dis- 
ease would pursue. Generally speaking, the epidetoiic 
spread from east to west ; the central part of the capital, 
from being most populous, suffering in greater proportion 
th^in localities not so crowded, while the suburbs fur- 
nished much fewer cases, especially towards the western 
portion, in which only several isolated examples appeared. 
Towards the sea-shore, and in buildings abutting on the 
quays, the complaint proved more virulent than elsewhere. 

Having become gradually more extended throughout 
August and September, the malady exhibited its maxi- 
mum intensity towards the third week of October, on the 
20th of which month 298 new cases were recorded, being 
the greatest nuimber ever occurring in one day. From 
that date the cases became dail}^ less frequent, and on the 
31st only 185 fresh attacks came under notice among the 
entire population of Lisbon. On the 4th of November,, 
however, 259 ncAV cases were recorded, thus showing a 
temporary augmentation. But afterwards the number 



470 HISTORY OF YELLOW FEVER. 

of cases diminished consecutively till the end of Decem- 
ber, when yellow fever ceased entirely. 

Statistics of the Epidemic. 

During the period mentioned — that is, while the epi- 
demic lasted, the cases registered amounted to 13,757 al- 
together. Of these, 7842 were treated at the patient's 
own domicile, 5161 in special hospitals, and the remain- 
ing 754 in other establishments. Considering many in- 
stances may have been overlooked when yellow fever first 
made its appearance in the Portugese metropolis, the 
Report states that most likely the total persons attacked 
reached 18,000; which, hence gives a ratio of one person 
affected by the epidemic in every eleven inhabitants. 
Eespecting the mortality, it is added that 5652 cases 
proved fatal, of w^hich 3466 died at the patient's own 
dwelling, 1932 in special hospitals, and the remaining 254 
in other public institutions. Consequently, the propor- 
tion of deaths ranged about one in thirty-five of the total 
population; and if the number of attacks be assumed at 
18,000, as the Council of Health believed, that would aver- 
age one fatal case to every 318 individuals affected. 

Married Men Suffered Much. 

Some interesting statistical deductions may be derived 
from the tables contained in the Eeport. For example, 
among the 3466 fatal cases which took place in private 
domiciles, 2061 were male and 1405 female patients, or 
146 of the former to 100 of the latter, the period of life 
which seemed most fatal being from thirty to forty years 
of age; while married men seem to have died in a much 
larger proportion than married females. Whereas wid- 
ows oftener fell victims to yellow fever than widowers, 
the proportion being about double in both categories ; 12 
married men liaving died to every 5 married women, and 
10 widows to every 53 widowers. 



LISBON — 1857. i71 

Mortality among Trades and Occupations. 

It is also curious, in reference to occupations, to know 
that more persons died who worked on wood than in 
metals; while those employed on leather also suffered 
considerably, as for instance, curriers and shoemakers. 
On the other hand, persons engaged in weaving silk and 
cotton, although they constituted a numerous body in 
Lisbon, only 24 deaths were reported against 108 among 
the leather workers.. 

Among professional men the mortality was greatly out 
of proportion to other classes. Thus 30 clergymen, 13 
physicians and 16 apothecaries died; besides 16 other 
medical practitioners who f^ll victims in the hospitals to 
yellow fever, or had retired to the country previojus to 
their deaths. If comparisons be made betwixt persons 
belonging to the liberal or educated professions, and in- 
dustrial laborers, the mortality proved much larger among 
the former than the latter, in reference to their relative 
numbers; 436 of the former category having died, or 
one-eighth of the entire amount recorded, which, much 
exceeds the ratio of those engaged in handicra,fts. 

Mortality in Hospitals. 

The Report gives a detailed account of the movement of 
patients attacked with yellow fever, who were received 
into the several hospitals when that malady existed in 
Lisbon. The total number treated in these institutioins 
amounted to 5161; of whom 4043 were males apad 1118 
females — 7 of the former to 2 of the latter sex ; the recov- 
eries being 3229, comprising 2499 males and 730 females; 
while 1932 died, or 1544 of! the former sex to 388 of the 
latter. According to such data, it therefore appears the 
average mortality ranged as one death in every 267 ad- 
missions; or in fi^e cases treated, about two died. The 
proportion of male patients received was at least three 
men to one woman; the fatal cases being, however, com- 
paratively, nearly analogous. In both sexes a very large 



47 J HISTORY OF YELLOW FEVZR. 

proportion of the deaths recorded took place in persons 
yarving from puberty to thirty years of age; 3003 fatal 
cases of the entire number previously stated haying oc- 
curred among patients at that period of life; Ts^hile only 
31 instances were reported in children at or under their 
tenth year. The largest number of deaths occurred in 
bachelors; next the married, and lastly widowers; while 
among female patients, fewer single women became yic- 
tims than in any other class of that sex. 

The movement of patients in the military hospitals who 
were attacked by the prevailing epidemic, next occupies 
the Board of Health's attention. According to their 
report, 626 men and officers were received into these es- 
tablishments during October, Xovember and December, 
of whom 503 were ctired and 123 died: thus showing a 
much smaller mortality than among the civil x)optilation. 
It is, however, worthy of remiark that the disease proved 
more fatal to officers than to common soldiers. Thus, 
out of 8 officers admitted, 6 died, whereas, among 501 
rank and file, the deaths were 91, or two in every eleven 
admissions, which therefore makes a remarkable differ- 
ence. It is also further interesting to mention that, 
among the 626 fatal cases recorded in military hospital^*, 
only 31 were married men and 1 widowers — hence, co- 
inciding with the remark made in reference to civilians 
attacked by yellow fever — viz., that bachelors oftener died 
than married men — while 122 were persons from twenty 
to thirty years of age. 

The MUitarif and Municipal Guards. 

Again, as the garrison of Lisbon and Belem then 
amounted to 5230 men, and the total deaths being 626. 
about one-eighth of the entire number thus fell victims 
to tlie epidemic, whereby the proportionate mortality ex- 
ceeded that noticed amons: the general population. The 
municipal guard also suffered considerably, since out of 
a force comprising 1161 men, 126 were attacked, of whom 
39 died. The horse-patrols of this body were, however, 



LISBON— 1857. 473 

less severely affected than the infantry; while patients 
treated ait their own dwellings exhibited a smaller com- 
parative mortality to those sent to the hospital. 

Mortality in- the Shipping. 

On board the ships of war at anchor in the Tagns, 
exactly 57 individuals were attacked, of whom only five 
died, which formed, therefore, a small mortality. In 
mercantile ships, the diseatse also m'ade very little Iiavoc^ — 
this immunity of the marine population being especially 
manifested among those guards who did duty on board 
of ships, and still more marked in a detachment compris- 
ing 120 men stationed at Belem, of whofm not one became 
indisposed. The very reverse was specially noticed re- 
specting persons employed in the arsenal, 291 ca,ses of 
yellow fever having been registered in that establishment, 
of whom 106 proved fatal, the most of these having been 
constantly employed on shore, although a few occasionally 
worked on board of ships. 

1858. 

In January, 1858, at a timie when the inhabitants of 
Lisbon had scarcely recovered from the terrible experi- 
ences which had overshadowed their native land, a few 
scattered cases of yellow fever were observed in localities 
where the disease had been especially malignant the year 
before. Prompt sanitary measures were taken and by 
the middle of of February, the incipient epidemic had 
been stamped out.^^ The number of cases is not stated, 
but eleven deaths are recorded during the period men- 
tioned. Grave fears were entertained by the government, 
it being predicted that the disease would again manifest 
itself during the summer months, but apart from the fact 
that the steamship Deti^ Amis, from Eio de Janeiro, after 
being subjected to a month's quarantine at Lisbon, car- 

^^ Berenger-Feraud, p. 133. 



474 HISTORY OF YELLOW FEVER. 

ried yellow fever to Ponta-Delgado, in the Azores ( q. t. ) ^^ 
nothing untoward happened to disturb the health condi- 
tions of the capital. 

1860. 

In the beginning of Ma^^, 1860, the Koyal Mail steamer 
Tyne touched at Lisbon on her way to Southami3ton. 
Yellow fever was prevailing on board and seventy-six pas- 
sengers, destined for Lisbon, were prohibited from land- 
ing by the health authorities. They were all huddled in 
the lazaretto, but no cases developing were allowed to 
proceed on their way after a few days' detention. 

1879. 

Kio de Janeiro again contaminated Lisbon in 1879. 

The English shij) Inmgene left Kio de Janeiro in the 
beginning of May, 1879, and arrived at Lisbon on the 
7th of the month, with forty-two passengers and a crew 
of eighteen. The captain reported that nine passengers 
and three sailors had died of yellow fever during the 
voyage. The vessel was sent to the quarantine station 
and thoroughly disinfected. Two of the workmen em- 
ployed in the disinfection of the vessel were attacked by 
the disease. These two cases were immediately isolated 
by the authorities and their lodgings fumigated and quar- 
antined. The infection did not spread.-^ 

1880. 

The history of yellow fever in Lisbon closes with a 
"suspicious case" in the beginning of June, 1880. The 
patient was attacked on June 10th, went through a severe 
spell of the disease, and was discharged cured on the 

-" See page 357 of this volume. 
=* Lancet (London), 1860, vol. 1, p. 386; Berenger-Feraud, p. 

136. 
'^ Berenger-Feraud, p. 168. 



OPORTO — 1850. 



475 



30th of the same month. The source of infection is not 
given by o;ur authority. ^^ 

OLIVAES. 

1857. 

The great epidemic which devastated Lisbon in 1857, 
spread to Olivaes, then a separate city of 23,000 inhabi- 
tants, but since 1883, a part of Lisbon. There is a record 
of 120 cases, 60 being fugitives from Lisbon. Our author- 
ity (Eager, loc. cit., p. 10) does not give the number of 
deaths. 

OPORTO. 

Description. 

■Oporto is the second largest city in Portugal, on the 
right bank and about two miles from the mouth of the 
Douro, 170 miles north of Lisbon. The appearance of 
the city on a first approach is very prepossessing, but 
in reality most of the streets are narrow, crooked and 
filthy, and the houses irregularly constructed. The prin- 
cipal trade is in wine, white and red, but chiefly the laitter 
{Port Wine, so named from this town). Oporto was at 
one time the capital of Portugal. It was at this place 
that Wellington routed the French in 1810, after the re- 
markable passage of the Douro. It was originally the 
Portus Gale of the Romans and was the stronghold of the 
Christians against the ferocious Moors in the early days 
of the Church of Rome. Populatioai: 1878, 105,838; 1890, 
139,856. 

Yellow Fever Years. 

1850; 1851; 1856; 1857; 1858; 1859. 
Summary of Epidemics. 
1850. 

There is no record of yellow fever having prevailed at 
Oporto previous to 1850, when two vessels from Brazil 
brought the disease to the ancient capital of Portugal. 

^^Firmo Ferrara des Santos: Jl. Soc. Science Med. de Lisboa, 
1881, vol. 45, p. 136. 



476 HISTORY OF YELLOW FEVER. 

In July of the year above mentioned, the ship Duarte 
IV entered the harbor of Oporto. Xo history of yellow 
fever on board was given by the captain, but five custom- 
house employes of the town who had been on board were 
taken ill a few days afterward and three died. The dis- 
ease was diagnosed as yellow fever, but the facts were 
witliheld from the public, for fear of creating a panic. 
The incident would undoubtedly have been unnoticed by 
the population had not a second infection taken place. 
The new focus was created by the Tentadora, also* fvipm 
Eio de Janeiro, which arrived at Oporto during Septem- 
ber, having lost five men from yellow fever during the 
voyage. Customhouse inspectors who had been sent by 
the health authorities to) investigate the health condi- 
tions on the vessel caught the disease and contaminated 
their fellowmen. Scattered cases cropped out through- 
out the town, but fortunately the cool season stopped the 
progress of the fever on October 19, after fifty deaths had 
resulted from the epidemic. The number of cases is not 
stated by our authority.-"^ 

1851. 

The Tentadora and Duarte IT, both from Eio de 
Janeiro, again infected Oporto in 1851. A third ship, 
the Santa Cniz, from Brazil, also imported the disease 
into the town that year. ' 

The Tentadora, which entered the port in August, had 
had five deaths from yellow fever during the voyage. 
Several customhouse employes who went on board the 
ship were taken sick and died of the dreaded disease. As 
in the year 1850, the infection did not spread from these 
initial cases, and the town would probably have escaped 
an invasion of the pest if proper precautions had been 
taken by the health authorities when the next ship ar- 
rived from Brazil. Eigorous sanitary measures were 
neglected, however, and a repetition of the disasters which 

-' Berenger-Feraud, p. 120. 



OPORTO — J 851. 4-77 

overran Portugal in the past was only prevented by the 
advent of the cool season, which put a quietus to the 
activities of the Calopae. 

In an account given by Eager,-^ it seems that the 
Duarte IV arrived at Oportoi on September 10, having 
had deaths aboard from yellow fever during the voyage. 
The vessel spent twelve days in quarantine. After being 
given pratique, two custom-house men posted aboard to 
guard the ship were attacked with the disease and died. 
A few days later, three laborers employed in removing 
the cargo from the hold, and several other person who 
had been on the vessel, were taken ill with the same 
malady. The disease afterwards spread in the quarters 
known as Miragaia ad Massarellos and altogether seven- 
teen persons died in consequence. 

While this incipient epidemic wais gradually spreading, 
there arrived from Brazil another vessel, the Santa Cruz. 
The same malady attacked the custom-house employees, 
the stevedores and other persons wlio< in one way or an- 
other had had direct relation with the infected ship. 
The popular alarm occasioned by these frequent appear- 
ances of fatal cases resulted in the appointment of a sani- 
tary commissiooa for the study of the mater and the recom- 
mendation of measures of betterment. Notwithstanding 
the vigorous means adopted to this end, cases continued 
to occur. The infection spread to tAvoi British vessels 
anchored down the wind from the pest ship Santa Ci^nz. 
The British vessels were supposed to be quite isolated 
from the Santa Cruz. Soon other cases appeared on two 
Portugese vessels anchored to leeward of the British ves- 
sels. Several of - the men of the Portugese vessels died. 

The epidemic which was of short duration, came toi an 
end on October 19, resulting in 100 cases and 40 deaths. 

1856. 

The third invasion of Oporto by yellow fever took place 

=« Eager: Bull. No. 4, Yellow Fever Inst, Wash., 1902, p. 9. 



i 



478 HISTORY OF YELLOW FtVER. 

in 1856, under identical conditions as in 1850 and 1851. 
Verily, the Lusitainians do< not profit by experience. 

The kingdom, which had been ravaged by cholera 'since 
il853, and which lost 3,275 of her inhabitants from that 
disease between October, 1855, and November, 1856, was 
hardly prepared for the invasion of a second foreign pesti- 
lence and the appearance of yellow fever at Opqrto in 
1856 caused widespread terror. 

According to Eager and Lyons,^^ early in July, some 
vessels arrived from Brazil, where yellow fever prevailed. 
July 12, the first cases appeared, and, as before the first 
persons affected were custojm-house employees, stevedores 
and those in contact with the suspicious vessels. Again 
a focus of infection was established in the Miragaia and 
Massarellos quarters. There were also iCases of yellow 
fever among the soldiers of the municipal garrison, but a 
marked difference was noted, both in the intensity of the 
symptoms and in the issue of the disease between the 
cases falling ill on board ship and those resulting from 
communication with infected foci on land. The first cases 
were congregated in a special hospital, and of these, six- 
teen ot oif twenty-one died. lOn the other hand, only ten 
deaths took place among the twenty- seven soldiers at- 
ta(cked. Energetic measures were taken by the authori- 
ties of the port. Certain of the vessels, being evidently 
deemed infected beyond hope of cleansing, were sunk at 
sea. 

The first case was observed July 12 and the last Octo- 
ber 2. A total of 120 cases and 63 deaths resulted from 
the outbreak. 

1857. 

The Tentadora, which, it will be remembered was one 
of the causes of the epidemics ofi 1851 and 1852 at Oporto, 
again brought yellow fever to that port in 1857. 



Eager: Loc. cit., p. 10. 



OPORTO — 1857. 479 

Almost simultaneously with the sitting of the Quaran- 
tine Congress at Paris in 1857, and while the terrible 
ravages of the epidemic which was then decimating Lis- 
bon, were being discussed and ways and means devised 
to stop its awesome progress, Europe was startled to 
learn that Oporto^, after successfully warding off the in- 
vasion from the capital of the Kingdom, had been infected 
by importation from a foreign country. Fortunately, the 
importation took place at the beginning of the cool season 
and did not spread. The facts are as follows: 

The Tentadorci arrived at Oporto, from Brazil, about 
the beginning of September, 1857. Several of her crew 
had died from yellow fever during the passage. It is 
said that one of the crew was missed while the vessel was 
on her way to Oporto and that, on the cajgo being dis- 
charged, his body was found in a state of decomposition 
in the ballast in the hold. Three persons from Oporto 
who boarded the vessel soon after her arrival, were at- 
tacked with the fever and died. The fourth case to erupt 
on shore was that of a store-keeper. This man had not 
been on board the Tantadora^ but had received in his store 
casks frosm tjie infected vessel.^^ 

The outbreak was confined to the cases above noted, 
while unfortunate Lisbon, only 170 miles to the south, 
and which had been infected in a similar manner, lost 
5,652 souls.^^ 

1858. 

A few cases in the harbor in 1858 proved to be the last 
echo! of the history of yellow fever in Oporto. ^^ The sick 
were promptly isolated and the infection did not spread. 
As fifty years have elopsed since, we trust that the health 
authorities of the former tapital of Lusitania, grown wise 
by past experiences, will continue to keep the foreign pest- 
ilence away from the shores of the little Kingdom. 

** Editorial: Medical Times and Gazette (London), 1857, vol. 
^^iSee page 467 of this volume for a description of the Libson 
epidemic of 1857. 
'* Berenger-Feraud, loo. cit., p. 135; Eager, loc. cit., p. 1?. 



480 HISTORY OF YELLOW FEVER. 

PENICHE. 

Description. 

Peniclie is a fortified town of Portugal, on the Atlantic 
and south side of the peninsular of Peniche. Population, 
2,963. 

Yellow Fever Year. 

1718. 

' Summary of Outbreak. 

According to Eodrigues de Avreu, quoted by Berenger- 
Feraud {Joe. cit., page 12), the first appearance of yellow 
fever in Portugal took place at Peniche in 1718, seven 
years before the great epidemic of Lisbon. As no details 
are given, we infer that the outbreak was limited to a 
few cases, probably in the shipping. 



HISTORY OF 



YELLOW FEVER 



IN 



SPAIN. 



SPAIN. 

Spain has been a nidus of pestilential disease from time 
immemorial. As far back as the year 1100 B. C, an epi- 
demic devastated that .country. It is recorded that this 
was followed by twenty-five years of drought without in- 
terruption; springs were dried up, rivers became ford- 
able, their waters becoming almost stagnant; there was 
neither pasture for beast nor fruit for man. So great 
was the barrenness, that there was scarcely any green 
things to be found, except some olive trees on the banks 
of the Ebro and the Guadalquivir. Such, says the his- 
torians of the period, was, the melancholy state of ancient 
Spain — ''full of dreadful mortalities, plagues and miseries 
of every description, which with immigration to other 
lands^ nearly depopulated our country." 

In the year 476 B. C, and the succeeding years, there 
prevailed in Spain, from time to time, a series of pesti- 
lences and other minor diseases by which a multitude of 
people perished. The Carthagenians, to appease the 
aiUger of the gods, to whom they attributed these fatal 
visitatio'S, offered human sacrifices, and made incisions 
in their arms, legs and on other parts of their bodies; 
they also immiolated cattle of all kinds, according to the 
severity of the pestilence. 

Ancient records speak of pestilential diseases in Spain 
in the years 427, 383, 237, B. C. 

During the Christian Era, fearful epidemics have rav- 
aged Spain ; but as our aim is simply to give a narration 
oif the progress of yellow fever in that country, we will 
not dwell upon them, referring the reader for fuller de- 
tails to that part of this work which treats of the ravages 
of pestilential disease in Europe. Suf&ce it to say that, 
at the present day, Spain is one of the healthiest countries 
in Europe and the favorite objective point of the tourist 
in quest of the romantic and beautiful. 



484 HISTORY OF YELLOW FEVER. 

Spain has suffered more from yisitations of yellow 
fever than all the other countries ofi Europe combined. 
At one time (1800 to 1830 j the disease seemed to haye 
taken up its i^ermanent abode within the confines of the 
Kingdom. The last general epidemic took place in 1821, 
although in 1870 cases were observed in several localities 
and fears were entertained that the great epidemics of the 
beginning of the century would be duplicated. Prompt 
sanitary measures were resorted to; and the progress of 
the pestilence checked. 

A reference to the year 1800 in our chronological table 
will show the appalling list of mortalities from yellow 
fever in Spain that year. Forty-six localities were in- 
vaded by the saffron scourge, causing a miortality of over 
62,000. ' In 1801, when thirty-eight localities were visited 
with a combined population of about 128,000, the death 
roll reached nearly 53,000, or one death for each eight 
inhabitaiUts. 

LOCALITIES IX SPAIX WHEEE YELLOW FEVER 
HAS BEEX OBSERVED. 

In Andalusia. 

Af/uilar de la Fronfera. A town twenty-two miles 
southeast of Cordova. Population, 12,300. 

Alcala de los Ga-ules. On the slope of the Ronda 
Mountains, thirty-seven miles east by south of Cadiz. 
Population, 5,516. 

Alcala de Guadajjra. A town seven miles east of Seville; 
situated on a hill. Population, 7,311. 

Alf/eziras. On the northwest coast of the Bay of Gib- 
raltar, and opposite the latter town : little elevated above 
the level of the sea: behind it are high ranges of moun- 
tains. Population, 14,2*29. 

Alhaurin el Grande. On an eminence, twenty miles 
west from Malaga. Population, 6,781. 

Almeria. On the Mediterranean. 101 miles east of 
Malaga. Population (1908), 46,806. 



SPAIN LOCALITIES AFFECTED. 485 

Antequera. In a plain betweien Granada and Seville, 
twenty-eight miles west of Malaga ; it is built partly on a 
rising ground; streets straight and wide. Population, 
27,201. 

Arahal. ;Twentj-two miles southeast of Seville. Pop- 
ulation, 9,287. 

Ai^cos de la Frontera. Situated on a very high rock, 
thirty miles north of Cadiz. Population, 15,378. 

Ayampnte. At the mouth of the Gruadiana, near the 
frontiers of Portugal, in a sterile country, eighty miles 
from Seville. Population, 5,972. 

Benaocaz. Sixty miles northeast of Cadiz. Population, 
1,960. 

Bornos. Twenty miles from! Cadiz. Population, 4,530. 

Cadiz, On the Isla de Leon, at the extremity of a nar- 
row neck of land, extending about six and one-half miles 
into the sea, sixty miles northwest of Gibraltar and sixty- 
four miles south of Seville. Population (1908), 69,382. 

Carmona. Eighteen miles northeast of Seville, on a 
hill. Population, 20,074. 

Catalan Bay. A small fishing village near Gibraltar. 

Chiclana. T^v^elve miles southeast of Cadiz. 

Carlota. Seventeen miles southwest of Cordova. Pop- 
ulation, 1,350. 

Chipiona. On a rock on the coast, near the mouth of 
the Guadalquivir, four miles from San Lucar and nine 
miles from Cadiz. Population, 500. 

Cof ia. Six miles south of Seville, on the Guadalquivir, 
Population, 3,756. 

Cordova. In a plain near the Sierra Morena, on the 
river Guadalquivir ; distant from the sea, seventy miles in 
a direct line, and eighty-six miles northeast of Seville. 
Population, 55,614. 

Cortes de la Frontera. Forty-eight miles southwest of 
Malaga. Population, 4,330. 

Bos Hermanas. Six miles southeast of Seville. Popu- 
lation, 3,498. 

^ Eclja. In a plain on the western bank of the Xenil, 
eighteen miles before its junction with the Guadalquivir, 



486 HISTORY OF YELLOW FEVER. 

in a fertile country, and eighty-two miles from Seyille. 
Population, 27,216.'^ 

El Borge. A small town near Malaga. Population, 
1,200. 

El Palo. 'A Tillage about three miles east o^' Malaga. 

Espejo. Twenty-five miles southeast of Cordova, in a 
plain on the river Guadajoz. Population, 5,420. 

Espera. Thirty-four miles northeast of Cadiz. Popu- 
lation, 1,822. 

Estepa. Fiftv-four miles from Seville. Population, 
8,133. 

Gibraltar. A fortified town and rock at the south ex- 
tremity of Andalusia, belonging to Great Britain. Popu- 
lation, (exclusive of garrison), 19,859. 

Granada. Beautifully situated on two spurs of the 
Sierra Nevada mountains, at an elevation of 927 feet above 
the sea level, forty-eight miles from Malaga and about 
thirtv-one miles in a direct line from the sea. Population, 
76,605. 

Huelva. On an inlet of the Atlantic, forty-nine miles 
southwest of Seville. Population (1908), 2-1,000. 

Isla de Leon. ■ On the east side of the island of the same 
name, seven miles southeast of Cadiz. Population, 18,202. 

La Ramhla. A town in the Province of and fourteen 
miles south of Cordova. Population, 5,9'26. 

Lehrija. Twenty-nine miles southwest of Seville, in a 
plain six miles from the river Guadalquivir. Population, 
10,328. 

Los Barrios, A small village, situated in the moun- 
tains, about fourteen miles west of Gibraltar, on the road 
to Cadiz. . 

Los Palacios. Twelve miles south of Seville. /Popu- 
lation, 1,835. 

Mairera del Alcor. Thirteen miles east of Seville. Pop- 
ulation, 4,406. 

Malaga. At the base of a range of/ hills, sixty-five miles 
east of Gibraltar. Population ^(1908), 135,000. 



SPAIN LOCALITIES AFFECTED. 487 

Medina Sidoma. Tw^enty-two miles southeast of Cadiz, 
and twelve miles from the sea. An old town, built on a 
high hill. Population, 9,703. 

Montilla. Eighteen miles southeast of Cordova; situ- 
ated partly on a hill. Population, 15,000. 

Moron-de-la-Frontera. Thirty-two miles northeast of 
Seville, at the foot of the chain of mountains, called Sierra 
de Eonda. Population, 12,846. 

Pwterna de la Rib era. Twenty-thjree miles east of 
Cadiz, at the foot of the Xerez Mountains. Population, 
1,500. 

Puerto Real. In Cadiz Bay, six miles from that city. 
Population, 6,544. 

Ronda. Situated in the midst of a range of mountains 
of that name, at a very great elevation above the sea; 
distant from Gibraltar, forty-two miles north. Popula- 
tion, 19,334. 

Rota. On the coast, three miles from Puerto Santa 
Maria, and six miles fromi Cadiz. Population, 6,972. 

^an Fernando. On the Isla de Leon, near Cadiz. Pop- 
ulation, 18,202. {Also known as Isla de Leon) . 

San Lucar de Barameda. At the mouth of the river 
Guadalquivir, eighteen miles north of Cadiz. Population, 
18,130. 

San Roque. Fifty- six miles southeast of Cadiz, and 
seven miles northwest of Gibraltar. Population, 60,458. 
Seville. On the river Guadalquivir; situated in an ex- 
tensive plain, sevein-two miles north northeast of Cadiz. 
Population (1908), 148,315. 

TJhrique. Forty-six miles northeast of Cadiz. Popu- 
lation, 4,876. 

Utrera. Sixteen miles southeast of Seville; situated 
between two hills. Population, 12,441. 

Vejer de la Frontera. Twenty-seven southeast of Cadiz, 
on a very high but cultivated hill, at a short distance from 
the sea, opposite Cape Trafalgar. Population, 7,662. 

Vele^ Malaga. Situated at about fourteen miles to the 
east of Malaga, on the slope of a hill, two miles from the 
sea, on the river Velez. Population, 12,523. 



488 HISOORY OF YELLOW FEVER. 

Vera. Thirty-nine miles from Almeria, about three 
mile from the Mediterranean, in a plain. Population, 
6,017. 

Villa Franca de la Marisma. Fifteen miles south of 
Seville. Population, 4,268. 

Villa Martin. Forty-three miles southeast of Seville, 
on the river Guadaleta. Population, 1,000. 

Xerez de la Front era. Sixteen miles north northeast of 
Cadiz, on a hill in a fertile country. Population, 61,523. 

Ximena de la Froiitera. Forty-six miles north of Cadiz, 
about twenty miles from Gibraltar, on a hill. Population, 
6,577. 

Ill Aragon. 

Fraga. Fifty-five miles southeast of Huesca. Popu- 
lation, 6, 695. 

Mequinenza. Sixty miles southeast of Huesca, on the 
Ebro and Segra; distant from the sea in a direct line forty 
miles. Population, 2,890. 

Xonaspe. A village near Mequinenza, on the small 
river Xonaspe. Population, 1,000. 

Balearic Islands. 

. Palma. Capital of the Island of Majorca, 130 miles 
south of Barcelona. Population, 58,221. 

Po7^t Malion. Capital of the Island of Minorca, situ- 
ated on its south side. Its port is one of the best and 
most commodious on the Mediterranean, i Population, 
18,588. 

In Catalonia. 

Asco. A small town on the right bank of the Ebro, 
partly on a hill, thirty-nine miles from Tortosa. Popu- 
lation, 1,300. 

Barcelona. In a plain on an extensive bay, having on 
its western side a high mountain. It is 312 miles east 
northeast of Madrid. Population (1908), 600,000. 



SPAIN LOCALITIES AFFECTED, 489 

Barcelonetta. A suburb of Barcelona, and on the same 
bay, distant from) the latter city, a quarter of a mile. 

Canet-deMar, Twenty-six miles northeast of Barcelona. 
Population, 3,301. 

Jesus. A village opposite Tortosa. 

Malgrat. Thirty-seven miles northeast of Barcelona. 
Population, 3,287. 

Olot. Twenty-one miles northeast of Gerona. Popu- 
lation, 9,984. 

Regens. A village five miles from; Tortosa. 

Roquito. On the Ebro, opposite Tortosa. 

Salou. Eight miles southwest of Tarragona. 

Sitges. Eighteen miles southwest of Barcelona. 

Tarragona. At the mouth of the Francoli, on a lofty 
rock, fifty-two miles from Barcelona. Population, 18,923. 

Tortosa. On the left bank of the Ebro, twenty-two 
miles from the sea and forty- three miles southwest of Tar- 
ragona. Population, 24,702. 

Ill Guipuzcoa. 

Passajes. On the Bay of Biscay, three miles east of 
San Sebastian. Population, 921. 

Ifh Murcia. 

ArcJiena. Fourteen miles northwest of Murcia, in a 
plain at the foot of a range of mountains, near river 
Segura. Population, 1,766. 

Cartagena. On a bay of the Mediterranean, twenty- 
seven miles southeast ofi Murcia. Population, 75,908. 

Cieza. Twenty-six miles northwest of Murcia. Popu- 
lation, 8,000. 1 

Jumilla. In Province of Carthagena, thirty-seven miles 
northwest of Murcia, at the foot of a hill, forty miles from 
the sea and sixty-five miles northwest of Cartagena. 
Population, 9,613.' 

Lorca. Forty-two miles southwest of Murcia. Popu- 
lation, 48,138. 



490 HISTORY OF YELLOW FEYER. 

Mazarro7v, Twenty miles west of Cartagena. Popu- 
lation, 3,745. 

Molina. Six miles from Murcia, and thirty-five miles 
from Malaga, in a plain, on the river Segnra. Popula- 
tion, 2,469. 

Min^ciw. On the river Segura, north of Cartagena. 
Population, 91,805. 

Ojos. Fifteen miles north of Murcia, in a narrow val- 
ley on the river Segura. Populat^n, 300. 

Palmar. Three miles south of Murcia. 

Bicot. Twenty-seven miles north of Murcia, in a plain 
at the foot of a range of mountains, and one and a half 
miles from river Segura. Population, 1,098. 

Sarria. ^Near Barcelona. Population, 3,752. 

Totana. Ten miles northwest of Lorca. Population, 
3,315! 

Villa Nueva del Ariscal. Seven miles from Seville. 
Population, 1,651. ^ 

In JSfeiD Castile. 

Madrid. Capital of Spain, in Xew Castile, in the cen- 
ter of the Peninsula, on the Menzanares River. Popula- 
tion (1887), 470,283; (1908), 556,663. 

Villaseca de la 8agra. Twelve miles northeast of 
Toledo. Population, 1,369. 

In Old Castile. 
San Andero. 

In Pontevadra. 

Vigo. Thirteen miles south southwest of Pontevadra. 
A lazaretto is maintained at this port. Population, 8,214. 

In Valencia. 

Alcantarilla. Five miles from Murcia. Population, 
4,089. 



SPAIN LOCALITIES AFFECTED. 491 

Alicante. In a fertile country, on tbe sea-coaist, at the 
foot of a hill, 800 feet high. Population, 42,500. , 

Guardamar. Twenty-one miles southwest of Alicante, 
at the mouth of the river' Segura. Population, 2,696. 

Oriliuela. In a plain, near a range of mountains, on 
river Segura, thirty- two miles from Alicante, and distant 
from the sea, fourteen miles. Population, 25,208. 

Palmar. Three miles south ot Murcia. 

Penacerrada. A small village, three miles from Ali- 
cante, consisting, at the time of epidemic, of forty-two 
families or 158 inhabitants. 

San Juan. A small village in the neighborhood of 
Alicante. 

Bans. A short distance north of Barcelona. 

Taharra. A small Jsland in the Mediterranean, five 
miles south of Alicante. Population, 500. 

Valencia. In a fine plain on the Guadalaviar, about 
two miles from the sea and 190 miles east southeast of 
Madrid. Population, 143,861. 

CHEONOLOGY OF YELLOW FEVER IN SPAIN, 
FROM 1649 TO 1890. 

1649. NGibraltar, Seville. (First appearance of yellow 
fever in Spain). 

1696. Castille; Navarre. 

Immunity. Forty-Six Years. 

1700. Cadiz. 

Immunity. Three Years. 

1701. Cadiz. 

1702. Cadiz. 

1703. Cadiz. 

Immunity. One Year. 
1705. Cadiz. 

Immunity. Ttventy-One Years. 
1727. Gibraltar. 



492 HISTORY OF YELLOW FEVER. 

Immunity. Two Years. 

1730. Cadiz. 

1731. Cadiz. 

Immunity. Ttvo Years. 
1734. Cadiz. 

Immunity. One Year. 
1736. Cadiz. 

Immunity. Three Years. 

1740. Cadiz. 

1741. Cadiz; Malaga. 

Immunity. Ttvo Years. 

1744. Cadiz; Palma. 

• 1745. Cadiz. 

1746. Cadiz. 

1747. Port Mahon. 

1748. Port Mahon. 

1749. Palma. 

Immtmitif. Three Years. 
1753. Cadiz. 

Immunity. Seven Years. 
1761. Cadiz. 

Immunity. One Year. 

1763. Cadiz. 

1764. Cadiz. 

1765. Cadiz. 

Immunity. Fourteen Years. 
1780. Cadiz. 

Immunity. Three Years. 
1784. Cadiz. 

Immunity. Five Years. 

1790. Cadiz. 

1791. Malaga. 

1792. Cadiz. 

Immunity. Six Years. 
1798. Gibraltar. 

Immunity. One Year. 
1800. Ailcala de los Gazules; Aralial; Arcos; Avriata; 
Ayamonte; Benaocoz; Bornosi; Cadiz; Caneta la Keal; 
Carmona; Chiclana; Cordova; Conil; Cortes de la Fron- 



SPAIN CHRONOLOGY, 1 649 TO 1890. 493 

tera; Coria; Dos Hermatiias; Ecija; El Arahal; Espreza- 
lena; Estepa; Gibraltar; Huelva; Isla de Leon; La 
Cabezas; Lebrija; Los Palacios; Maireno; Medina Sidonia; 
Montejuge; Moron de la Frontera; Olivera; Paterna de 
la Kiviera; Puerto de Santa Maria; Puerto Eeal; Rota; 
Eonda; San Lucar de Barameda; Santa Caridad; Sarria; 
Seville; Tribujena; Ubrique; Uterera; Yejer; Villamartin ; 
Villaluneja; Xeres de la Fronteira. 

Total localities infected in 1800, forty-seven. 

1801. Cadiz; Medina Sidonia; Seville. 

1802. Cadiz ; Carmona ; Cliurianna ; Cordova ; Malaga ; 
Medina Sidonia. 

1803. Algerziras; Alicante; Antequera; Barcelona; 
Barcelonette ; Cadiz; Coirunn'a; Espera; Gibraltar; la 
Eambla; Malaga; Montilla; Palma; Eonda: 

1801. Alcada de los Pandoras; Algerziras; Alhaurin- 
el-Grande; Alicante; Antequera; Arcos de la Frontera; 
Ayamonte; Balearic Islands (Majorca); Cadiz; Car- 
tagena; Churriana; Coin; Cordova; Ecija; El Borge; El 
Palo; Espejo; Espera; Gibraltar; Granada; Guardamar; 
La Eambla; Los Barrios; Malaga; Mijas; Montilla; 
iMoron de la Frontera; Murcia; Palma; Paterna de la 
Eibera; Pena-Serrada ; Puerto de Santa Maria; Eonda; 
San Juan ; San Eoque ; Torre-Molino ; Yelez-Malaga ; 
Vera ; Villamartin ; Xeres de la Frontera ; Ximines de la 
Frontera. 

Total localities infected in 1801, forty-one. 

Immuniti/. Two Years. 

1807. Cadiz. 

1808. Cadiz. Xeres de la Frontera. 

Immunity. One Year. 

1810. Aiberca; Barcelona; Cartagena; Cadiz; Gib- 
raltar; Seville. 

1811. Alicante; Alcantarilla ; Cadiz; Cartagena; Gib- 
raltar; Isla de Leon; Jumila; Lebrija; Lebrillo; Lorsa; 
Medina-Sidonia; Murcia; Tobarra; Totana; Ziesar. 



494 HISTORY OF YELLOW FEVER. 

Total localities infected in 1811, fifteen. 

1812. Cadiz; Cartagena; Cieza; Jumilla; Murcia. 

1813. Cadiz; Catalan Bay; Gibraltar; Malaga; Me- 
dina- Sidonia; San Andero. 

1814. Cadiz; Catalan Bay; Gibraltar. 

Immunity. Ttuo Years. 

1817. Cadiz. 

1818. Gib-altar. 

1819. Barcelona ; Cadiz ; Cbiclana ; Isla de Leon ; Port 
Malion; Puerto de Santa Maria; Puerto Eeal; San Lucar 
de Barameda; Seville; Xeres de la Frontera. 

Total localities infected in 1819, eleven. 

1820. Cadiz; Alcala de los Gazules; La Carlotta; 
Malaga ; Puerto de Santa Maria ; Mequinenza ; Xeres de la 
Frontera. 

1821. AgTiilas; Asco; Badalona; Barcelona; Bar- 
celonette; Canet de Mar; Fraga; Jesus; Las Arguilas; 
Lebrija; Xonaspe; Malaga; Malgrat; Mequinenza; Monte 
AlegT-e; Clot; Palma; Pedrara; Port Mahon; Puerto de 
Santa Maria; Roquetas; Eota; Salou; San Gervaiso; San 
Lucar de Barameda; Sans; Sarria; Seville; Sitges; Tor- 
tosa; Villa Secca; Xeres de la Frontera. 

Total localities infected in 1821, thirty-two. 

1822. Corunna; Gibraltar. 

1823. Loyola; Passajes. 
1821. Gibraltar. 

1825. Gibraltar. 

1826. Gibraltar. 

Immunity. One Year. 

1828. Catalan Bay Gibraltar. 

1829. Gibraltar. 

Im^munity. Ticenty -eight Years. 
1858. Ferrol ; Vigo. 



SPAIN CHRONOLOGY, 1649 TO 1890. 495 

Immunity. Eight Years. 
1867. Madrid. 

Immunity. Tico Years. 
1870. Alicante; Barcelona; Madrid; Palma; Port 
Mahon; Tortosa; Valencia. 

Immunity. Seven Years. 

1878. Madrid. 

1879. Pedroches. 

Immunity. Three Years. 
1883. Barcelona. 

Immunity. Five Years. 

1889. Vigo. 

1890. Malaga. (Last appearance of yellow fever in 
Spain). 

Chronology of Yellow Fever in Spain^ by Localities. 

1649 TO 1890. 

A star (*) placed after a name means that authorities 
consulted do not state the year of the prevalence of the 
disease. 

Aguilar de la Frontera.* 

Aguilas. 1821. 

Alaurinego. 1804. 

Albama,* ' 

Alberca. 1810. 

Alcala de Guadayra.* 

Alcala de los Gazules. 1800 ; 1820. 

Alcala de los Panaderos. 1804. 

lAlcantarilla. 1811. 

Alcaria.* 

Algeziras. 1803; 1804. 

Alhaurin-el-Grande. 1804. 

Alicante. 1803 ; 1804 ; 1811 ; 1870. 

Almeria.* 

Antequera. 1803; 1804. 



1703 : 


17(15 : 


1730: 


1731 


1714 


1715 : 


1716; 


1753 


17S1 


1790 : 


1792 : 


ISOO 


ISOS 


ISIO ; 


ISll; 


1812 


1S21. 









496 HISTORY OF YELLOW FEYER. 

Aralial. ISOO. 

vlrchena." 

Ai-'cos de la Froutera. ISOO : 1>01. 

Asco. 1S21. 

Aviiata. ISOO. 

A.Tamoure. ISuO : ISOl. 

Badalona. 1S21. 

Barcelona. 1S03 : IMO : 1S19; 1821; 1870; 1883. 

Bai-celonette. 1803: 1821. 

Barrio de Perchel. 1S03 : ISOl. 

Benaocaz. ISOO. 

Bornos. ISOO. 

Cadiz. 1700: 1701: I7n2 : 
1733; 1731; 1736: 17l(i: 1711 
1761; 1763; 1761: 1765: 17S0 
1801: 1S02: 1803; ISOl: 1S07 
1S13: ISU: 1S17: 1819; 1S20: 

Canet-de-Mar. 1821. 

Caneta-la-Eeal. 1800. 

Carmona. ISOO; 1802. 

Carraca. 1800. 

Carrana.* 

Cartagena. 1753; 1801; 1810; 1811; 1812. 

Ca.stille. 1696. 

Catalan Bav. 1813 : ISll; 1S2S. 

Chiclana. ISOO : 1S1[^. 

Chipiona.* 

Churriana. 1802: ISOl. 

Cieza. 1811: 1S12. 

Coin. 1801. 

Conil. 1800. 

Cordova.. 1800 : 1802 : 1801. 

Coria. 1800. 

Cortes de la Frontera. 1800. 

Cornnna. 1803; 1822. 

Dos Hermanos. 1800. 

Ecija. 1800; 1801. 

El Aralial. ISOO. 

El Boro:e. 1801. 

Elche.*' 



SPAIN CHRONOLOGY, BY LOCALITIES. 497> 

El Palo. 1804. 

Eprezalena. 1800. 

Escala.* 

Espejo. 1803 ; 1804. 

Espera. 1800; 1804. 

Estepa. 1800. 

Ferrol. 1858. 

Fraga. 1821. 

Gibraltar. 1649; 1727; 1798; 1800; 1803; 1804; 1810; 
1811; 1814; 1818; 1822; 1824; 1825; 1826; 1828; 1829. 

Granada. 1804. 

Guardamar. 1804. 

Huelva. 1800. 

IsladeLeoB. 1800; 1811; 1819. 

Jesus. 1821. 

Jumilla. 1811 ; 1812. 

La Cabezas de San Juan. 1800. 

La Carlotta. 1800; 1820. 

La Kambla. 1803 ; 1804. 

Las-Aguilas. 1821. 

Lebrixa. 1800; 1811; 1821. 

Los Palacios. 1800. 

Lorsa. 1811. 

Los Barrios. 1804. 

Loyola. 1823. 

Madjrld. 1867; 1870; 1878. 

Mairena del Alcor. 1800. 

Malgrat. 1821. 

Malaga. 1741; 1791; 1802; 1803; 1804; 1813; 1820; 
1821; 1890. 

Mazarron.* 

Medina-Sidonia. 1800; 1801; 1802; 1811; 1813. 

Mequinenza. 1821. 

Mijas. 1804. 

V^Iolina.* 

Monte Alegre. 1821. 

Montejugue. 1800. 

Montilla. 1803 ; 1804. 

Moron de la Frontera. 1800 ; 1804. 

Murcia. 1804; 1811; 1812. 



498 HISTORY OF YELLOW FEVER. 

Navarre. 1696. 

Nonaspe. 1821. 

Ojos.* 

Olivera. 1800. 

Olot. 1821. 

Oriliuela.* 

Palma. 1744 ; 1749 ; 1803 ; 1804 ; 1819 ; 1821 ; 1870. 

.Palmar.* 

Pasajes. 1823. 

Paterna de la Eibera. 1800 ; 1804. 

Penacerrada. 1804. 

Pedrara. .1821. 

Pedroches. 1879. 

Port Malion. 1747; 1748; 1819; 1821; 1870. 

Puerto de Santa Maria. 1800 ; 1804 ; 1819 ; 1820 ; 1821. 

Puerto Real. 1800 ; 1819. 

Ricote.* 

Ronda. 1800; 1803; 1804. 

Roquetas. 1821. 

Rota. 1800; 1804; 1821. 

Saint Eloy.* 

Salou. 1821. 

San Andero. 1813. 

San Gervaiso. 1821. 

San Juan. 1804. 

San Luear de Barameda. 1800 ; 1819 ; 1821. 

San Roque. 1804. 

Sans. 1821. 

Santa Caridad. 1800. 

Sarria. 1800; 1821. 

Seville. 1649 ; 1800 ; 1801 ; 1810 ; 1819 ; 1821. 

Sitges. 1821. 

Tabarca. 1804. 

Tarragona.* 

Tobarra. 1811. 

Tortosa. 1821 ; 1870. 

Totana. 1811; 1812. 

Torrenela.* 

Torre-Molino. 1804. 

Ubrique. 1800. 



SPAIN. 499 

Utrera. 1800. 

Valencia. 1870. 

Vejer de la Frontera. 1800. 

Velez Malaga. 1804. 

Vera. 1804. 

Vigo. 1858; 1889. 

Villafranca.* 

Villamartin. 1800; 1804. 

Villalunueva del Ariscal. 1800. 

Villa Seca. 1821. 

Xeres de la Frontera. 1800; 1804; 1808; 1819; 1820; 
1821. 

Ximines de la Frontera. 1804. 

Yelar.* 

Ziera.* 

Total number of cities in Spain in which yellow fever 
has been observed from 1649 to 1890, a period of two hun- 
dred and forty-one years, 144. 



SUMMAKY OF EPIDEMICS. 
AGUILAS. 



1821. 



The little port of Aguilas, in Murcia, on the Mediter- 
ranean, was infected by the brig ^aint- Joseph, from 
Malaga, in 1821. It had then a population of 700. Vesr 
sels from Cadiz also brought yellow fever cases to the 
town. There were 75 cases and 25 deaths.^ 



*iCheTvin: Examen de rAdministration en Matiere Santaire. 

Paris, 1827, p. 91. 
^Fellowes: Reports of the Pe tilential Disorder of Andalusia, 

etc., (London, 1815), pp. 181, 185. 



500 HISTORY OF YELLOW FEVtR. 

ALBEROA. 
1810. 

Refugees from Murcia, four miles distant, infected Al- 
berca in 1810. There was no diffusion of the disease.* 

ALCALA DE LOS GAZULES. 

1800. 

Alcala de los Gazules, situated on the slope of the Ronda 
Mountains, thirty-seven miles southeast of Cadiz, was 
contaminated by refugees from the the last named locality 
in 1800, and lost 817 of its inhabitants.^ 

1820. 

The second and last appearance of yellow fever at Alcala 
de los Gazules took place in 1820. A native of the town 
went on a visit to Xeres de la Frontera,, contracted the 
malady and died on his return to Alcala. The infection 
did not spread.^ 

ALCALA DE LOS PANDEROS. 

1804. 

The inhabitants of the village of Alcala de los Panderos, 
located about four miles from Seville, proved remarkably 
immune from yellow fever during the great epidemic of 

*Bonneau and 'Sulpicy: Recherches sur la iContagion de la 

Fievre Jaune, Paris, 1823, p. 364, 
2 La Roche: Yellow Fever, etc. (Phila., 1855), p. 534. 
Alfonso da 'Maria: Memoria Sobre la Epidemia de Andalusia, 

p. 122. 
^Jackson: Remarks on the Epidemic Yellow Fever which has 

appeared at intervals on the iSouth Coasts of Spain 

(London, 1821), p. 41 (foot note). 



SPAIN. 501 

1804. The place, which takes its name from the occupa- 
tion of its inhabitants, who are mostly bakers, and fur- 
nished nearly all the bread consumed in Seville at the 
time, was in daily cummunication with the latter place, 
where, out of a remaining population of 80,000, oyer 
76,000 are said to have been attacked by yellow fever; 
yet, in spite of this, only twenty-four persons had the dis^ 
ease in the village, eighteen of which died.^ In every in- 
stance, those attacked had communicated with Seville. 
Aside from these, not a single case erupted in the village. 
Jackson, Fellowes, Berthe and others who have written at 
length on the epidemics of Spain, ascribe this remarkable 
immunity to the fact that aromatic herbs were burned in 
the ovens of the innumerable bakeries in the village, claim- 
ing that this purified the atmosphere and rendered the 
"miasmata" inocuous. The logical explanation in these 
days of enlightment, is that the fumes of the "aromatic 
herbs" were distasteful to the nostrils of the yellow fever 
mosquitoes and kept them away from the locality. 

ALCANTAEILLA. 
1811.' 

iAlcantarilla ("the little bridge") was contaminated hy 
refugees from Murcia, in 1811. The outbreak was not ex- 
tensive and the mortality was small.^ 

ALGEKZIRAS. 

1803. 

In 1803, smugglers brought yellow fever from Gibraltar 
to Alger ziras. Only a few^ cases resulted.^ 

- * Bancroft: An Essay on the Disease Called Yellow Fever 
(London, 1811), p. 460. 
^ Berenger-Feraud : Traite Theorique et Pratique de la Fievre 

Jaune, Paris, 1890, p. 84. 
^ Berenger-Feraud, p. 74, 



502 HISTORY OF YELLOW FEVER. 

1804. 
Ill 1804, Algerziras liad a population of about 14.000. 
Yellow fever, which was widespread in Sixain that year, 
soon made its appearance in the town, but was confined to 
one or two streets. The mortality was small.^ 

ALHAUEIN-EL-GKAXDE. 

1804. 

A few cases of yellow fever, all imported, were observed 
at Alhaurin in 1804, i)rincipally in persons communicat- 
ing with Malaga. The disease did not obtain a' foothold 
in the villa 2:e.^ 



'&' 



ALICAXTE. 

1803. 
Government officials patrolling the coast are accused of 
having brought yellow fever to Alicante in 1803. Other 
authorities attribute the outbreak of the disease to a bale 
of cotton goods from Gibraltar, which had been surrepti- 
tiously taken into Alicante and hidden in the residence 
of the port commissioner. The latter was the first victim 
of the outbreak, which was not extensive and resulted in 
only a few cases and deaths.^ 

1804. 

The ill-starred inhabitants of Alicante were less fortu- 
nate in 1804. The first case of yellow fever was observed 
August 9. The town, which had a population ol? 13,957, 
had taken great precautions to prevent an importation of 
the disease, and when the news spread that the pestilence 
was in their midst, the inhabitants became terror-stricken 



'Fellowes, p. 101 (foot note) 
^Fellowes, pp. 181; 182. 
'^ Berenger-Feraud, p. 74. 



SPAIN ALICANTE. 503 

and all who could do so sought fancied security in flight. 
It is of record that 2,110 fled to the neighboring country, 
leaving 11,847 within the focus of the disease. Out of 
this number, there resulted 6,971 attacks, of which 2^,472 
I)roved fatal. It is a notable fact that the disease was 
more fatal to men than women, 1,552 of the former suc- 
cumbing, while the fatalities among the latter amounted 
to 920. The disease manifested its greatest intensity on 
October 9, gradually subsiding after that date and becom- 
ing extinct on December 13.^^ 

■ 1811. 

i^licante was infected by Gibraltar in 1811. Only a 
few cases were observed. ^^ 

1870. 

During the outbreak of yellow fever which devastated 
Barcelona in 1870, some cases were imported into /Ali- 
cante. 

The virulence of the epidemic and the rapidity with 
which it spread, brought back to the minds of the terror- 
stricken inhabitants, the horrors of the pestilences which 
had laid waste the flourishing cities of Andalusia, in the 
beginning of the century. Alicante had a population of 
25,000 in 1870. When news of the eruption of the flrst 
case (September 13) became public, and the flrst death 
was recorded (Septeniber 14), the alarm was general, 
and in less than a week, 12,500 or half the population 
fled. . 

" Sumimarized from the works of: 

Moreau de Jonnes: Monographie HistoTique et Medicale de la 
Fievre Jaime des Antilles, Paris, 1820, p. 341. 

Bally: Typhus d Amerique ou Fievre Jaune, Paris, 1814, p. 90. 

La Roche, loc. cit., p. 536. 

Fellowes, loc. cit., p. 478. 

Chervin: iSeoond Report on Quarantine, London, 1852, p. 203. 
" Berenger-Feraud, p.. 84. 



504- HISTORY OF YELLOW FEVER. 

The epidemic raged most fiercely between October 20 
and November 15. Aifter the last named date, it grad- 
ually subsided and became extinct on December 13, when 
the last death took place. 

Following is the summary of caises and deaths, taken 
from the interesting report of Bergez y Dufoo,^^ after 
divesting it of the sonorous verbiage and on.erous details 
which ever characterize the writings of the Castilliansi : 

Cases. Deaths. 

Men 3,857 Men 1,082 

Women 1,012 Women : 228 

Children 484 Children 70 



5,353 1,380 

Of the 70 mortal cases among children, 44 were boys 
and 26 girls. 



ANTEQUEEA. 

The first appearance of yellow fever at Antequera took 
place in 1803. The infection came from Malaga. IThe 
outbreak was unimportant.^^ 

1804. 

In 1804, yellow fever appeared at Antequera on August 
2. It was brought to that place by Joseph Delgado, a 
journeyman tailor, who, in dread of the malady which had 
begun its ravages at Malaga, fled to his father's house at 
Antequera. He left Malaga on the 23rd of July, was 
taken ill on the 27th, and died on the 2nd of August. His 
mother was attacked on the 15th of the same month, and 
died on the 24th. One of his brothers sickened on the 

"Bergez y Dufoo: Siglo Medica (Madrid), 1871, vol. 18, pp. 280, 

311, 327, 437. 
^^ Berenger-Feraud, p. 74. 



SPAIN — ANTEQUERa. 505 

17th, and died on the 21st. Two sisters were taken ill 
on the 18th, one died on the 22nd; the other recovered. 
Another brother, a youth about 11 years, was attacked 
on the 19th ; he recovered. The fiather of this unfortunate 
family, aged 75, was taken ill on the 28th of( August, and 
died on the 2nd of September ; and, finally, the remaining 
brother, aged 26, was attacked on the 30tli of August, and 
died on the 4th of September. 

Another refugee from Malaga created a new focus of 
infection at Antequera almost simultaneously with the 
importation of Delgado. A lady by the name of Munoz 
fled from Malaga and sought refuge among friends at 
Antequera. She arrived about the end of July, was taken 
ill on the 1st of August, and died on the 7th. The servant 
who attended her and six of the family where she lodged 
fell victims toi the disease. 

A third focus was created b^^ a woman named Eosario, 
who arrived at Antequera from Malaga on the 7th of 
August, already indisposed. She died on the 12th. The 
master of the house where she lodged was taken ill on the 
19th of August, and died on the 25th. His wife was 
attacked on the 23rd, and died on the 27th.i4 

From these three foci, the infection spread with incredi- 
ble swiftness and the entire city was soon under its in- 
fluence. 

In the beginning of October, the death-rate was between 
thirty and forty daily. The populace, who looked upon 
the pestilence with superstitious terror, sought to arrest 
its progress by religious demonstrations. On the evening 
of October 12th, they formed into a solemn procession and 
marched through the streets until three o'clock in the 
morning, singing hymns and bearing alofft a picture of 
Our Lady of the Rosary.^^ The folly of a multitude parad- 
ing the streets of an infected city soon made itself evident, 

"Jackson, loc. cit., p. 19. 

♦'During the terrible epidemic which ravaged Cadiz in 1800 a 

similar demonstration was made by the fanatical populace. 

See page 530 of this volume. 
"Bally, p. 436. 



506 HISTORY OF YELLOW FEVER. 

for on the fourth day following the demonstration, the 
deaths increased from forty to eighty each day. 

The last death took place November 6. Out of a popu- 
lation of 14,577, there were 2,490 deaths, dirided as fol- 
lows: Males, 1,850; females, 1,090.^^ 

Since 1804, ^elloAv fever has never been observed at 
Antequera. 

AEAHAL. 

During the widespread epidemic of 1800, a few hundred 
cases were imported to Arahal, twenty-two miles from 
Seville, resulting in 180 deaths. 

AECOS DE LA FEOXTEKA. 

1800. 

Arcos de la Frontera was infected by Cadiz in 1800, and 
lost 631 of her inhabitants.^^ 

1804. 

In 1804, Arcos de la Frontera had a population of 9,894. 
The first case of yellow fever was observed on August 13, 
and between that date and December 3, when the last 
death took place, 184 victims paid tribute to the pestil- 
ence. Of this number, 113 were males and 71 females.^^ 

ASCO. 

1821. 

Asco, a small town on the Ebro, thirty-nine miles from 
Tortosa, was infected in a peculiar manner in 1821. It 

^''Fellowes, p. 478. 
^^La Roche, vol. 1. p, 534. 
'' La Roche, vol. 1, p. 47S. 
'"Fellowes, p. 478. 



SPAIN. 507 

appears that a man from Tortosa was visiting friends in 
Asco, when he was informed that his wife had been taken 
suddenly ill. Impatient to return home, he borrowed a 
horse from his host, promising to send back the animal 
the following day. On arriving at his destination, the 
unfortunate Tortosan was stricken with the malady which 
was then prevailing in his native town (yellow fever), 
and died in a few days. The party at Asco to whom the 
horse belonged, not hearing any tidings of his property, 
sent his servant for the animal. The latter, on reaching 
Tortosa, was told of the death of his master's friend and 
given permission to take back the animal. On his return 
to Asco, he was stricken with yellow fever, communicated 
the disease to his master, who in turn infected the balance 
of the family, and from this focus, radiated an epidemic 
which threatened to encompass the town. The inhabi- 
tants fled to the neighboring country. This', checked for a 
time the progress of the malady, and Asco was congratu- 
lating itself upon having escaped with only a few cases 
and deaths, while Tortosa and Barcelona were being de- 
populated, when the infection broke out anew. An in- 
vestigation by th^ health authorities to discover the source 
of the secondary dnfection, as Asco had established a strict 
quarantine against places where the malady was then pre- 
vailing, revealed that four thieves had broken into a house 
where yellow fever had been most murderous, and had 
ransacked it from top to bottom of everything valuable. 
These four lavv- breakers paid dearly for their depredation, 
for they were shortly after stricken with yellow fever and 
died. From this source radiated the second outbreak. 
Another general exodus of the population took place. The 
commissary of Asco caused every dog in the town to be 
killed (for reasons not explained by the chroniclers of the 
period) , opened wide the doors and windows of every habi- 
tation for six consecutive days, and forbade the inhabi- 
tants to return until the epiflemic was completely stamped 
out. These energetic measures saved Asco from de- 
population.^o 

^•^ Bally, Francois and Pariset, p. 59, 



508 HISTORY OF YELLOW FEVER. 

AVEIATA. 

1800. 

A few cases of yellow fever were observed at Avriata 
in 1800. There is no record of any other invasion pre- 
vious to or after that date.^^ 

AYAMONTE. 

1800. 

Ayamonte is one of the few places in Spain where yel- 
low fever has been observed only infrequently. Fellowes 
claims that it suffered to some extent in 1800, but does not 
give any details.^^ 

1804. 

Chervin^^ pokes fun at Pariset because the latter sol- 
emnly asserts in his work published in 1820,^* that yellow 
fever was introduced into Ayamonte in 1804 by means of 
cheese and crackers^^ smuggled into the town from Gib- 
raltar by a fisherman. As yellow fever was quite severe 
at Gibraltar in 1804, and it was proved that the lone fish- 
erman had communicated in the open sea with a vessel 
coming from the infected port, there is no doubt in the 
world that he contaminated Ayamonte, for he died of the 
disease on his return home ; but we side with Chervin in 
exonerating the cheese and crackers. Cheese sometimes 
(especially in summer) contains animalculae, but it has 
never been known to harbor the larvae of the winged dis- 
seminators of yellow fever. 

^^Rougeau: Theses de Paris, 1827, No. 119. 

^^ Fellowes, p. 444. 

^* Chervin: Examen Critique, etc., p. 18. 

^* Pariset: O'bservaticns sur la Fievre Jaune, p, 88. 

23 * * * <'^^ moyen du fromage et du biscuit." 



SPAIN. 509 

The unfortunate fisherman communicated the disease 
to his family, who all fell victims to the pestilence. The 
fever invaded the three streets contiguous to the fisher- 
man's home, but did not spread to other quarters of the 
town. The number of cases and deaths is .not given by our 
authorities.^^ 

BADALONA. 

1821. 

A workman living at Badalona, six miles from Barce- 
lona, contracted yellow fever at the latter place, and was 
transported to his home, where he expired the following 
day. The authorities of Badalona had the body trans- 
ported outside the town limits, and threatened to shoot 
any one who should harbor refugees from infected places. 
These stringent measures saved the village from con- 
tamination.* 

BALEAKIC ISLANDS. 

Yellov^^ Fever Years. 

1744 ; 1747 ; 1748 ; 1749 ; 1803 ; 1804 ; 1819 ; 1821 ; 1870. 

Summary of Epidemics. 

1744. 

Pal ma. 

Berenger-Feraud^" and Pariset-^ give vague accounts of 
an outbreak of yellow fever on the Island of Majorca in 
1744. Whence the fever was imported or what ravages it 
caused, is left to conjecture. 

^Fellowes; Ohervin; Bally, Francois and Pariset. 

* Bonneau and 'Sulpicy: Recherches sur la Contagion de la Fievre 

Jaune. Paris, 1823, p. 306. 
^ Berenger-Feraud, p. 48. 
-« Pariset, p. 123.. 



510 HISTORY OF YELLOW FEVER. 

1747. 
Port Mahon. 

According to Cleghorn,^ the second appearance of yel- 
low fever in the Balearic Islands took place on the Island 
of Minorca in 1747. 

No particulars of any historical value are given con- 
cerning this importation. 

1748. 

Port Mahon. 

It is recorded that the disease was present at Minorca 
in 1748.30 

No authentic data concerning this invasion are ob- 
tainable. 

1749. 

Palma. 

The fourth invasion of the Balearic Islands took place 
at Majorca in 1749, according to Cleghorn.^^ 

The literature on the subject is as unsatisfactory as in 
the preceding outbreaks. 

1803. 

Palma. 

A vessel J^om Alicante brought yellow fever to Palma 
in 1803.32 

The outbreak was unimportant. 

^ Clegborn: Observations on the Epidemic Diseases of Minorca, 
from the Year 1744 to 1749 (London, 1779). Also: 
Berenger-Feraud. 

'•^ Moreau de Jonnes, p. 336. 

^1 Eager, p. 16. 

'- Berenger-Feraud, p. 74. 



SPAIN BAiuEARIC iSLANDS. 511 

1804. 

Palma. 

The state of the public health at Palma was excellent in 
1804, when a Tessel arriyed from Alicante, having on board 
a Major can who was convalescing from an attack of yel- 
low fever, and a family destined for the Island of Minorca. 
The latter took lodgings at Palma, intending to leave for 
their native town in a day or so. On the same day of 
tlieir arrival, the mother of the family was taken ill with 
yelloAv fever. The following day, the husband and child 
were attacked. The unfortunates were immediately sent 
to the pest-house, but some soldiers who frequented the 
tavern where the stricken family had taken lodgings, con- 
tracted the disease and brought the infection to the town 
barracks, where several cases were observed. The dis- 
ease did not spread through the town.^^ 

1819. 

Port Malion. 

In 1819, yellow fever ravaged the cities on the south 
coasts of Spain. The infection was originally brought by 
the ship Asia, from Vera Cruz and Havana, to the Isla de 
Leon, and infected Cadiz. The Asia was sent to the quar- 
antine station at Port Mahon, where three inhabitants of 
the town contracted the disease and died. The outbreak 
was limited to these three cases.^^ 

1821. 
Palma. 

In 1821, another great epidemic wave of yellow fever 
desolated the sea coast cities of Southern Spain. 

^ Berenger-Feraud, p.. 79. . 

^* Begin: Journal de Medecine Militaire, 1820, p. 346. Also: 
Berenger-Feraud, p. 89. 



512 HISTORY OF YELLOW FEVER. 

On August 6, 1821, a vessel left Barcelona, where ''a 
suspicious fever'' was beginning to cause much public un- 
rest, and arrived at Palma two days later. Among the pas- 
sengers was a merchant of Palma, who lived in the La Paz 
Quarter. On his arrival home, the merchant was taken 
ill with yellow fever. He was nursed by his wife and his 
little daughter and recovered. The girl was soon attacked 
and died with black vomit on the fifth day. The women 
who prepared the girl for burial were mostly all attacked 
and died. The merchant's wife was next attacked. She 
was transported to a house in San Pedro Street, where 
she recovered. The two adjoining houses were con- 
taminated. 

The merchant was visited during his illness by two 
friends, Poulet and Eoig and by two female relatives, 
Munera and Femina. These four persons were soon after 
taken ill with yellow fever and died. Poulet's wife and 
all her- children next fell victims to the disease. A man 
named Renz, who lived in a small room in the house of 
the Munera woman, soon succumbed to the fever. The 
man Roig, who died of the fever, contaminated his clerk, 
Mulct and five or six persons who roomed in his house. 
When Mulct's wife felt the first febrile symptoms, she fled 
with her children and a servant to a remote quarter of 
the town, which was free from sickness at the time. She 
soon died of the disease and was followed by her children 
and the servant who had accompanied her. 

Such was the pre-epidemic situation in Palma, when 
the authorities finally awoke from their lethargy. 

Up to September 10, the malady had been confined to 
the two districts — La Paz (yr Puyg de San Pedro and the 
Boleria, but cases began to crop out so rapidly, that 
the authorities decided to take urgent measures to check 
the inroads of the fever. News of the contemplated move 
on the part of the authorities reached the inhabitants of 
the infected districts, and fearing that they would be 
surrounded by an impenetrable sanitary cordon, entire 
families fled in the middle of the night to relatives or 
friends all over the city. This wholesale migration acted 
like a firebrand in spreading the fever, and the epidemic 
was soon bevond control. 



SPAIN BALEARIC ISLANDS 5 IS 

Panic seized the inhabitants. 

It was now a question of everyone for himself. Fathers 
deserted their families, mothers their babes, and inde- 
scribable terror prevailed in the town. On September 15, 
the superior authorities, civil and m^ilitary, fled to the 
village of Valdemosa, about twelve miles from Palma. 
The citizens, following their example, made a precipitate 
retreat to the country beyond the walls of the pest-ridden 
city. The migTation was so considerable that of 36,000, 
only 12,000 remained, 24,000 fleeing from the terrible pest- 
ilence. The government found it necessary to raifee funds, 
secure means of maintenance and build huts in the open 
country, and two encampments were formed at the foot 
of Mount Belver, about two miles from Palma. It is a 
remarkable fact, out of this multitude fleeing from a nest 
of pestilence, not a single case erupted, save in those who 
already had the disease when they joined in the frenzied 
exodus. ^^ 

There were altogether 7,100 cases in Palma, ofi which 
5,341 died. 

Port Malioiv. 

During the epidemic which ravaged the seacoast towns 
of Spain in 1821, forty-three vessels were quarantined at 
Port Mahon, beginning with the Javegue ConsUtucion^ 
from Barcelonai, August 13, 1821, and ending with the 
Luad Santo Gristo del Gran, October 24, 1821. 

Among the total of 196 cases of yellow fever, 122 died. 
Owing to the vigilance of the health authorities, the dis- 
ease did not spread to the inhabitants of Port Mahon. 

Among the 49 atteindants at the Lazaret Nacional at 
Port Mahon, 10 were attacked with yellow fever, five of 
whom died. These cases and deaths are included in the 
above total. 

3"' Bally, Francois and iPariset, p. 63. 

^« Junta (Superior de Sanidad de dicha Isla de Minorca, etc., 
Mahon, 1821. 



514 HISTORY OF YELOW FFVKR. 

1S70. 

Pahna. 

For nearly fifty years after the sinister epidemic of 
1821, yellow fever was kept out of Palma. In 1870 a few 
cases were imported to that town from the south coast 
of Spain, where the disease had been originally brought 
to Barcelona in Augnist by the ship La Maria, from 
Hayana. Prompt sanitary measures were resorted to, and 
the outbreak at Palma was confined to a few cases.^^ 

We have seached diligently through files off Spanish 
journals for a history of the prevalence of the disease 
at Palma, in 1870, but the results have been negative. 
On page 630 of El Siglo Medico for 1871, is a reference 
to an article entitled ^^Historia de la Fiebre Amarilla que 
se Padecia en Palma de Mallorca en 1870," but, with the 
characteristic haziness which generally pervades the lit- 
erature of the Castillians when it come® to facts and 
figures, the article conveyed nothing tangible. 

Port Mahon. 

We were more fortunate in gathering information con- 
cerning the prevalence of yellow fever at Port Mahon in 
1870. The infection did not spread to the shore, but was 
confined solely to ships in the quarantine basin. 

According to El Siglo Medico for 1871, vol. 18, pages 
233, 260, 310 and 406, the fjollowing infected ships were 
quarantined at the lazaretto during the epidemic of 1870 : 

1. Steamship Menorca, from Barcelona, September 15. 
Carried three women ill with yellow fever, who were re- 
moved toi lazaretto. Two died. 

2. Bark Dunamarguesa. Arrived from Barcelona, 
September 17. Three of the crew were afflicted on the 
way from Barcelona. On arrival, a third case died. On 
September 21, a patient was carried to the lazaretto from 

" Berenger-Feraud, p. 145, 



SPAIN PORT MAHON, 1870. 515 

this vessel, and died on the 28th. On September 28/ 
one of the health-guards was attacked and died. 

3. Steamship Union arrived from Barcelona, Septem- 
ber 23. Two passengers were found to be indisposed, and 
were sent to the lazaretto. Both died, one the same day 
and the other six days later. Another fatal attack on 
the 24:th. Another case on the 26th, followed by recovery. 

4. Steamship Mallorca, from Barcelona, September 
24. Among six passengers, one had yellow fever and died 
on the fourth day. 

5. Brigantine Nuevo Gopernico, from Barcelona, Sep- 
tember 28. Two cases sent to lazaretto. One died. 

6. Polacre Grieza Evangelist a , from Barcelona, Sep- 
tember 25. Three attacks during voyage. One died at 
sea. Other two sent tO' lazaretto ; both died. 

7. Warship Lepanto^ f^om Barcelona, September 23. 
On October 4, gunner's mate attacked; on the 5th, 6th 
and 7th, two sailors and a cabo de canon were attacked. 
All recovered. 

8. Ship San Juan, October 2. First case October 4; 
carried to lazaretto where he died several hours later. 
On October 5, a second case; recovery. 

9. Gunboat Ligera, from Barcelona, October 16. On 
the 22nd, disenibarked a case of yellow fever ; recovery. 

10. Brigantine Jnanita, from Barcelona, October 8. 
On the 11th, one case sent to lazaretto; recovery. 

General summary : 

First case, September 15; last, October 22. 

First death, September 17; last, Octobecr 4. 

Total cases, 22; total deaths, 12. 

With the exception of the health-guard who was in- 
fected on the Dunamarguesa, not a single inhabitant of 
Port Mahon contracted the disease. 

Since 1870, the Balearic Islands have been free from 
yellow fever. 



516 HISTORY OF YELLOW FEVfiR. 

BAKCELONA, 
Yellow Fever Yeaes. 
1803; 1810; 1819; 1821 (Great Epidemic) ; 1870; 1883.' 

SUMMAEY OF EPIDEMICS. 

1803. 

The first authentic importation of yellow fbver to Bar- 
celona took jDlace in 1803. While the fever was raging at 
Malaga, cases began to erupt in the harbor of Barcelona. 
Five soldierSj who had been placed on duty on board 
vessels, were attacked and died. Their colonel next fell 
a victim to the malady. The cases, which were confined 
to the shipj)ing, amounted to 73, of which 30 proved 
fatal.ss 

1810. 

Yellow fever is said to have been present at Barcelona 
in 1810. We have been unable to obtain any details con- 
cerning this alleged outbreak. The Medico- Cliirurgical 
Journal and Review (1821, vol. 2, p. 19,), claims that yel- 
low fever "raged" at Barcelona during the year under ob- 
servation, but efforts to corroborate this statement have 
been fruitless. Cadiz, Gibraltar, Seville and Carthagena 
suffered from the saffron scourge that year, and a few 
cases were probably brought to Barcelona or erupted on 
vessels in the harbor ; but there certainly was no epidemic 
in the ancient capital of Catalonia in 1810. If there had 
been, Berenger-Feraud, Audouard, Bally, Pariset, Eager 
and others who have written interestingly of the epidemics 
which ravaged Spain in the beginnins^ of the last century, 
would certainly have made note of the occurrence. 

^ Bally, p. 84. Bally, Francois and Pariset, p. 461. 



SPAIN ^BARCELONA. 5 J? 

1819. 

A solitary case of yellow fever was observed in Barce- 
lona in 1819, according to Eobert.^^ Our authority does 
not go into details, but states that the case erupted in 
July, and proved fatal in a few days. There was no 
diffusion. 

1821. 

The epidemic of 1821 was appalling and has gone into 
history as one of the most murderous on record. 

The population of Barcelona in 1821 was 150,000. When 
the true nature of the ^^mysterious disorder" which was 
causing widespread anxiety to the inhabitants of the 
ancient city became known, 80,000 fled precipitately to 
all points of the compass. Of the 70,000 who remained, 
nearly every one was attacked and between 16,000 and 
20,000 died, according to the estimates of various au- 
thorities.* 

TJiG Pest-Shijjs from Havana. 

The dismal history of this epidemic, as condensed from 
the works of O'Halloran,^^ Audouard,^^ Bally, Francois 
and Pariset,^^ Eager^^ and Berenger-Feraud,^^ is as 
follows : 

The following vessels are accused of having brought 
yellow fever to Barcelona in 1821 : 

3^ Robert: Guide Sanitaire, vol. 1, p. 88. 

* La Roche (Vol. 1., p. 536) says that these figures axe exagger- 

ated and iplaces the cases at 14,000 and the deaths at 9,730. 
**' O'Halloran: Remarks en the Yellow Fever on the South and 

East 'Coasts of Spain (London, 1823), pp. 22 et seq. 
"Audouard: Relation Historique et Medicale de la Fievre Jaune 

qui a Regne a Barcelone en 1821, Paris, 1821. 
*- Bally, Francois and Pariset: Histoire Medicale de la Fievre 

Jaune (Paris, 1823), p.p.. 4 et seq. 
*^ Eager: Bull. No. 5, Yellow Fever Inst, 1902, p. 22. 

* Bally, Francois and Pariset: p. 613. 

**Academia de Medcina y Cirurgia de Barcelona: Memoria soibre 
la Epidemia de Febre Amarilla Sufrida a Barcelona en 

1870. Borcelona, 1872, page 148. 

Also: Berenger-F^raud, p. 91; Roux, Marseilles Medicale, 

1871, vol. 8, p. 194. 



518 HISTORY OF YELLOW FEVER- 

1. The brig Talla Piedra 

2. The brig Nuestt^a Senora del Carmen. 

3. The brig Gr^an Turco, 

4. The Spanish frigate La Libert ad. 

The above named vessels sailed from Havana on April 
28, 1821, and were part of a fleet consisting of fifty-two 
sails, destined for the following ports : thirteen for Cadiz, 
twenty for Barcelona, six for Comma, three for Santan- 
der, four for Malaga, one for Vigo, one for Ferrol, one for 
Bilboa, one for Palma, one for Lisbon and one for Bahia, 

A cursory glance into the history of these four pest- 
ships proves interesting. 

The Talla Piedra touched at Cartagena on June 12, 
arriving at Barcelona on the 19th of the same month. 
She was given pratique after having performed eight days' 
quarantine. 

The Nuestra Senora del Carmen arrived at Cartagena 
on June 16, obtained pratique and disembarked her sec- 
ond pilot. She arrived at Alicante June 19, where she 
unloaded part of her cargo and embarked a passenger. 
The Carmen finally cast anchor in the harbor of Barcelona 
on July 11. This vessel had three cases of yellow fever dur- 
ing the voyage from Havana to Alicante, one of which 
proved fatal. The passenger who had boarded the ship 
at Alicante, was ill when the ship arrived at Barcelona, 
but eluded the vigilence of the authorities by sitting on 
deck ''all dressed up'' when the vessel entered the port. 
He died a few days after landing, of a malady which pre- 
sented "strange and suspicious symptoms." This was no 
doubt the first case of yellow fever at Barcelona in 1821, 
but the man who had been taken on board through charity 
and had no parents or influence, was buried by the city 
without any inquiries being made about his previous per- 
sonal history. 

The Gran Turco reached Cadiz on June 5, where she 
obtained pratique, disembarked twenty-four passengers 
and took on board four others and three sailors. She 
then set sail for Barcelona, where she arrived June 29. 
The Gran Turco had formerly been a slave-ship. During 



SPAIN BARCELONIA, 1821. 519 

the voyage from Havana, there had been some deaths from 
yellow fever on board. 

The frigate La Lihertad arrived at Malaga on June 8, 
obtained pratique and disembarked part of her cargo ; she 
then sailed for Cartagena, where she also landed some 
freight, a passenger and a sailor, after which she left for 
Barcelona, where she arrived June 28. 

Which of these four vessels contaminated Barcelona, or 
whether they each played a role in bringing the disease 
from Havana, has never been satisfactorily elucidated to 
this day; but that the onus fell on the quartette, there 
is not the slightest doubt. 

The First Seeds of the Epidemic. 

The state of the public health was excellent at Barce- 
lona. Great preparations were being made by the civil 
and military authorities, as well as the general public, 
for a great festival to be held July 12, to celebrate the 
anniversary of the promulgation of constitutional law in 
Spain. Owing to bad weather on the selected date, which 
would have marred the eclat of the celebration in the 
harbor, where elaborate manouevres were to be held, the 
feast was postponed until the following Sunday, July 15. 
On that day, the sky was cloudless and the weather splen- 
did, and the populace congregated on the quays to witness 
the nautical sports. There were then about twenty ships 
from Havana and Vera Cruz in the harbor, and they took 
part in the celebration. Captain Sagredas, cammanding 
the Gran Turco, gave a reception on board his ship. His 
wife, their children, his brother-in-law, sister-in-law and 
many other persons, altogether forty, attended. After 
spending a couple of days aboard the Gran Turco, the 
captain's family went to Barcelonetta, near Barcelona, 
where they lived. In a few days, every member of this 
family sickened "of a strange malady," and all died. Of 
the forty persons who had visited the Gran Tnrco, thirty- 
five died, with pronounced symptoms of yellow fever. 

Many persons visited the Talla Piedra during the pro- 
gress of the festival. In a few days, they were all taken 



520 HISTORY OF YELLOW FEVER. 

ill with the same "strange malady," and the majority 
died. 

The French brig Josephine was riding at anchor close 
to the above named vessels. The crew was taken ill with 
yellow fever, and only a few survived. The Saint-Joseph^ 
from Naples, also moored near the infected vessels, was 
contaminated and lost most of her crew. 

The captain of the Josephine, when he saw the havoc 
wrought on board his ship, took lodgings in Barcelona. 
Eight days afterwards, this lodging house was infected, 
and the landlady, her husband, their children and the 
servants were attacked in rapid succession. 

Shortly after the death of captain Sagredas' family and 
the fatal cases in the lodging house above mentioned, cases 
of the same "strange and suspicious malady'' began to 
crop out here and there in Barcelona and neighboring 
villages on the sea-shore, mainly among those who had 
communicated with the infected ships or who had visited 
the houses where cases had erupted. While the disease 
was slowly gaining ground, the "eminent physicians" of 
Barcelona were in daily conclave, wrangling over the sit- 
uation and refusing point-blank to admit that they were 
face to face with an invasion of yellow fever. It was only 
after the malady had invaded nearly every quarter of the 
town that the authorities saw that they had been blunder- 
ing and began the institution of sanitary measures to stop 
the progress of the "mysterious malady." But it was too 
late — the demon of pestilence was unchained and Barce- 
lona was destined to pay a terrible penalty for the criminal 
negligence of those sworn to safe-guard her interests. 

On August 5, the health authorities began sending the 
sick to isolation hospitals, but this had little effect in 
arresting the progress of the malady, for the people, 
deluded by the manifestos of the Spanish physicians deny- 
that the "mysterious malady" was yellow fever, openly 
defied the law and violently opposed interference with 
their business and pleasure. 



SPAIN — BARCELONA, 1821. 521 

' Panic and Flight. 

On August 12, the situation became so grave, that the 
number of isolation hospitals were increased, and per- 
emptory instructions given that the places of amuse- 
ment be closed and public assemblages prohibited. The 
populace violently opposed these measures, and riots were 
of daily occurrence. The local medical society sustained 
public opinion, denying that the disease was yellow fever. 
Under this state of things, the pestilence, unchecked by 
concerted preventive measures, was soon beyond control, 
and the deaths became daily more frequent and the malady 
more aggressive and widespread. 

On August 16, the public finally awoke to the real situ- 
ation and a panic ensued. In the space of) a few days, 
half the population of the town had fled. 

An example of the f^eatrful mortality may be deduced 
from the fact that out of 853 male and 886 female patients 
treated at the Seminary Hospital between September 13 
and November 25, 640 of the former and 622 of the latter 
died. 

Between August 16 and the first days of October, the 
ravages of the epidemic were terrible. In the beginning 
of October, 400 deaths were daily recorded. At the end 
of the month, the situation improved and by the middle 
of November, health conditions were nearly normal. On 
November 25, the last case erupted, but it was not until 
December 18 that the authorities relaxed their vigilance 
and withdrew the sanitary cordon which had completely 
shut out communication between Barcelona and the out- 
side world. 

Thus came to an end one of the most awesome epidemics 
of yellow fever on record, which has been unsurpassed 
for its fierceness and appalling mortality (21,483* out of a 
remaining population of 70,000), and which could have 
been controlled in its incipiency, but for the ignoirance of 
the people and the shameful wrangles and pig-headedness 
of the physicians whO' controlled the destinies of the un- 
fortunate city. 



522 HISTORY OF YELLOW FEVER. 

1870. 

For forty-nine years, Barcelona enjoyed a total im- 
munity from yellow fever. 

Early in August, 1870, the ship Maria arrived at Barce- 
lona from Havana. There had been two deaths on board 
during the voyage. In spite of this, the vessel was given 
free pratique, without being required to undergo the neces- 
sary sanitary formalities. The physicians of the port and 
the secretary of the sanitary office, who visited the vessel 
and gave her a clean bill of health without making strict 
inquiries, were taken ill with yellow fever a few days 
after their return home and died. Members of their fam- 
ilies were next stricken, and the disease by this means 
spread through the city. During the months of August 
and September, the malady became epidemic and a gen- 
eral exodus of the population took place. Toward the end 
of October, the daily mortality varied from twenty-five to 
forty. 

The epidemic came to an end in the early days of Novem- 
ber, resulting in 2,510 cases. Of these, 1,250 died, oir 49.8 
per cent. 

The disease extended to Valencia, Alicante, Palma and 
Madrid. The total mortality in Spain that vear amounted 
to 2,658.^4 

1883. 

The last appearance of yellow fever in Barcelona took 
place in 1883. In October of that year, the ^an Jose, 
from Havana, arrived at the port. Two men employed 
in discharging guano from the vessel were taken ill with 
yellow fever and died.^^ .The cool season undoubtedly 
saved Barcelona from an invasion of the Antillean pest- 
ilence. 

BARCELONETTE. 

1803. 
A few cases of yellow fever were observed in Barcelo- 

*^ Berenger-Feraud, p. 189. 



SPAIN BARCELONA. 523 

nette in 1803, imported from vessels in the harbor. There 
was no spread of the disease. (Pariset^ p. 38). 

1821. 

The seeds of the great epidemic which desolated Bar- 
celona in 1821, were sown at Barcelonette, a suburb of the 
first named city. The little burg was infected on July 16, 
by parties who had been on board the ship Gran Turco, 
and the first death took place July 26. The history of this 
epidemic is so closely associated with that of Barcelona, 
that a reference to the preceding pages will suffice to place 
the reader in touch with the distressing events which 
shrouded Spain in gloom during the year under 
consideration.^^ 

BAKKIOS. 

1804. 

Barrios, near Algerziras, was infected in 1804 by sol- 
diers forming part of an escort which had left Cadiz with 
a consignment of money.^"^ On the night of September 11, 
the cavalrymen stopped at the village inn, where one of 
their members was taken ill and died on the morning of 
the 13th. The yellowness of the cadavre excited the sus- 
picions of the authorities, and steps were at once taken 
to prevent a spread of the disease. The stegomyiae were 
already infected, however, and within two weeks six cases, 
followed by death, erupted in the immediate neighborhood 
of the lodging-house. No other cases were observed. 

BENAOCAZ. ; 

1800. 

During the general epidemic of 1800, a few cases were 
observed at Benaocaz. The outbreak was unimportant.^** 

*" Audouard, loc. cit, gives a comprehensive and interesting 

account of this epidemic. 
^' Bally, ,p. 444. 
^^Rougeau: Theses de Paris, 1827, No. 19. 



524 HISTORY Ot YELLOW FEVER. 

BOKNOS. 

1800. 

The epidemic of 1800 spread to Bornos. The number of 
cases is not stated, but the mortality amounted to 17.^^ 

CADIZ. 

Historical Resume. 

iCadiz is one of the most ancient cities of Spain. It was 
founded by the Phenicians, and early became of great com- 
mercial importance. It is situated at the extremity of a 
tongue of land which juts out from the Isla de Leon, is 
well built, well paved, and for a Spanish city, very clean. 
Cadiz, in common with other cities of Spain, has oft' • 
been the scene of exciting political disturbances and, in 
the past, has been besieged, taken and sacked by the 
Romans, the English and the French. Its present popu- 
lation is estimated at 69,322. 

The Epidemics of Cadiz. 

According to Pellowes,^^ the first great sickness of 
Cadiz of which there is any account, appeared in the year 
1466. In 1507, an equally fatal malady prevailed there. 
The disorder, on both occasions, was supposed to be the 
plague, although the word peste, used by Spanish authors, 
is applied to infectious disorders in general. 

Of the sickness which broke out in Cadiz in 1582, little 
can be ascertained. It is said to have ceased through the 
intercession of St. Roque, to whom the city dedicated a 
chapel. 

In 1649, the plague was introduced into Cadiz, and 
lasted three years, causing a mortality of over 14,000. 

In 1661, the plague again appeared. 

^''La Roche, vol. 1, p. 534., 
^°Fellowes, p. 22. 



SPAIN — CADIZ. 525 

From 1661 to 1700, when el vomito negro (black vomit) 
first made its appearance in Cadiz, there is no (record of 
any extraordinary change in the state of the public health 
in that historic city. 

Cadiz, being the wej^ttermost port of Spain and directly 
in the path of an extensive trans- Atlantic commerce, is 
more exposed to infection from the West Indies and South 
America than any other city on the Iberian Peninsula. 
Since 1700, when the first authentic importation of yellow 
fever took place, the city has suffered from thirty-nine 
visitations of the disease. Five of these outbreaks (1730, 
1731, 1800, 1804 and 1819) were attended with fearfhil 
mortality. 

.Yellow Fever Years. 

1700; 1701; 1702; 1703; 1705; 1730 (Great Epidemic) 
1731 (Great Epidemic); 1734; 1736; 1740; 1741; 1744 
1745; 1746; 1753; 1761; 1763; 1764; 1765; 1780; 1784 
1790; 1792; 1800 (Great Epidemic); 1801; 1802; 1803 
1804 (Great Epidemic); 1807; 1808; 1810; 1811; 1812; 
1814; 1817; 1819 (Great Epidemic) ; 1820; 1821. 

Summary of Epidemics. 

1700. 

Vessels from the West Indies are said to have brought 
yellow fever to Cadiz in 1700.^^ Beyond this mere state- 
ment, no other information is of record concerning this 
importation. 

1701. 

A few cases of yellow fever were imported to Cadiz in 
1701. There was no diffusion of the malady.^^ 



'^ Bereiiger-Feraud, p. 38. 

'^Arejula: Archives de Medecine Navale, vol. 7, p. 251. 



526 HISTORY OF YELLOW FEVER. 

1702. 

Unofficial reports allege that yellow fever was present 
in Cadiz in 1702.^^ These probably refer to cases in the 
harbor, as we could find no record of the preyalence of the 
malady in the town that year. 

17U3. 

^^Ships from America" are said to have inrected the har- 
bor of Cadiz in 1703. We could find no authentic docu- 
ments to substantiate this allegation. 

1705. 

According to Father Labat."*^ the vessel on which he 
was a passenger was quarantined at Cadiz in 1705, owing 
to the fact that a ship previously arrived from the West 
Indies had brought yellow fever to the town. The rev- 
erend chronicler does not state whether the disease was 
still prevalent when he arrived. 

1730. 

The epidemic of 1730 is the first of which any authentic 
record exists. All previous outbreaks of yellow fever 
which are said to have prevailed in Cadiz lack sub- 
stantiation. 

The squadron of Admiral Pintado, contaminated at the 
West Indies, brought the fever into Cadiz in 1730. The 
mortality was high, but no details are given by our 
authority.^^ 

1731. 

Fellowes (page 23) states that yellow fever "prevailed 
with equal fury" in the year 1731. Two symptoms were 
particularly noted as being most fatal in this disorder, 

'•"Berenger-Feraud, p. 39. 

"Labat: Xouveau Voyage aux lies d'Amerique, Paris, 1742. 

"Berenger-Feraud, p. 44; Fellowes, p. 23. 



SPAIN CADIZ. 527 

viz., spots of a livid yellow or dark color, and were the 
certain forerunners of the black vomit. The Spanish 
physicians were of the opinion that the malady was of! a 
pestilential nature, and they advised the magistrates to 
take the necessary precautions. The Court was then at 
Seville, and Don Josef Cervi, physician to Carlos III (at 
that time Duke of Parma and Placentia), was directed 
to send a practitoner from Seville to examine into thel 
origin and character of the disorder which was raging in 
Cadiz. For some unexplained reason, the result of this 
investigation was never published and the full extent of 
the epidemic which devastated Cadiz in 1731 is left to 
conjecture. 

1733. 

Spanish tradition^^ asserts that yellow fever was pres- 
ent in Cadiz during the year 1733. No authentic docu- 
ments have been found giving any detailed description of 
this outbreak, but the prevalence does not appear to have 
been extensive. 

1734. 

A mild epidemic of yellow fever prevailed in Cadiz in 
1734. Authors are divided as to whether this outbreak 
was due to new importation from the West Indies or the 
sea coast towns of Atmerica or a repullulation of the germs 
of the previous year.^'^ 

1736. 
A few cases were observed in 1736.^^ 

1740. 
Another mild manifestation in 1740.^^ 

^« Bally,, p. 42 ; Eager, p,. 15. 

^^ Berenger-Feraud, p. 45. 

^^ Beirenger^eraud, p. 45. 

^^ Bally, p. 44; Berenger-Feraud, p. 47, 



5 88 HISTORY OF YELLOW FEVER. 

17^1. 



YelloTv fever prevailed at Cadiz in 1741.^'^ That same 
year, nearly 10,000 persons died from the disease in 



Malaga. 



1744. 



Cadiz was again afflicted in 1744, the infection being 
brought by vessels from the West Indies. The outbreak 
was of moderate intensitv.^^ 

1745. 

In 1745, another mild manifestation.®- 

1746. 

A vessel from Cuba infected Cadiz in 1746.^^ 

1753. 

The squadron of Admiral Don Pedro de la Cerda 
brought fever from the West Indies to Cadiz in 1753. The 
outbreak was not extensive.^^ 

1761. 

A few cases were observed in 1761. according to 
Pariset.*^^ 

1763. 

The outbreak of 1763 was quite severe, and was 
imported by '"a vessel from America." There had been 
several deaths from yellow fever on board during the 
voyage, but the captain concealed this fact from the 

** Berenger-Feraud, p. 47. 

•^ Eager, p. 16. 

•= Berenger-Ferraud, p. 49. 

** Eager, p. 16; Berenger-Feraud, p. 49. 

•* Eager, p. 16. 

•^Pariset: Histoire Medicale de la Fievre Jaune Observee en 



SPAIN CADIZ. 519 

authorities and the vessel was admitted to pratique im- 
mediately upon her arrival. Shortly afteir^ cases broke 
out in a tavern where sailors from this vessel had lodged, 
and thence spread to the adjoining housesi, occupied by 
the poorer classes. The progress of the malady was slow, 
but it finally spread to other quarters of the town and 
caused much m;ortality. Ships near the shore suffered, 
but those anchored a mile or more from the wharves were 
not infected.^^ 

1764. 

In the month of September 1764, the traditional "ship 
from America" brought yellow fever to Cadiz. Chroniclers 
disagree as to the extent of the epidemic, but Lind,^'^ a 
recognized authority, states that it was very fatal, a hun- 
dred deaths being recorded in a single day. 

1765. 

In the month of April, 1765, two persons visited a room 
where cases had occurred the year before and ransacked 
some old clothes which had been left undisturbed in a 
closet since the death of the occupants of the house. The 
couple were shortly after taken ill and died with the 
characteristic symptoms of yellow fever. The malady 
did not spread. ^^ 

1780. 

A few cases were observed in 1780.^^ 



''•^ Berenger-Feraiid, p. 53. 

''' Lind: Diseases Incidental to Europeans in Hot Climates (First 

American Edition, 1811), p. 91. 

^^ Berenger-Feraud, p,. 54. 

^'Hirsch: Deutsche Vierteljahrssclirift fur Offentl. Gesdhts.- 

Pfleg., vol. 4, part 3, pp. 353-377. Also: 'Berenger-Feraud, 

p. 57. 



530 HISTORY OF YELLOW FEVER. 

1784. 
Sporadic cases were observed in 1784.'''^ 

1790. 
Scattered cases erupted in 1790.'^^ 

1792. 
A few cases are recorded for 1792."^^ 

1800. 



We now come to a recital of the greatest epidemic of 
yellow fever whicli has ever invaded Cadiz, and which, 
radiating into neighboring localities, plunged Spain in 
mourning. In Cadiz alone, one-sixth of the population 
perished in the space of little more than three months. 



Havana^ the Eternal Source of Infection. 



Assording to the various authors who have written 



^" Robert, Guide Sanitaire, vol.. 1, p. 88. 

Berenger-Feraud, p. 58. 

Pariset, p. 104. 
^^ Robert, vol. 1, p. 88; Pariset, p. 104. 
" Robert, vol, 1, p. 88. 

Berenger-Feraud, p. 60. 

Pariset, p. 104. 



SPAIN CADIZ, 1800. 5S1 

on the subject/^ the importation of the disease is attri- 
buted to the brig Dolphin, which sailed from Havana at 
the end of May, 1800, arrived at Charleston, S. C, on the 
30th of the same month, whence she sailed on June 11, 
after embarking three sailors, finally arriving at Cadiz 
on July 6. 

When the vessel arrived at Cadiz, the captain ^reported 
that three of the crew had died from yellow fever during 
the voyage across the Atlantic. He was refused pratique 
and the vessel remanded for observation. On July 15, 
after ten days of apparently rigid isolation, and twenty 
days after the last death, the health of all on board being 
reported perfect, the vessel was permitted to disembark 
her passengers and discharge her cargo. 

Two other vessels are also suspected of having infected 
Cadiz : 

"iSee the following works: 
Bally, Typhus d'Amerique, p. 70. 
Bancroft, Essay on Yellow Fever, p. 439. 
Berenger-Feraud, p, 68. 
Berthe: Precis Historique de la Maladie qui a Regne en 

Andaloucie en 1800. Paris, 1801. 
Eager: Bull. No. 5, Yellow Fever Inst., p. 16. 
Fellowes, p. 37.. 
Ameller: (Description de la Enfermedad Epidemica que tuva 

Principio en la Ciudad de Cadiz, etc., 'Cadiz, 1800. 
Arejula: Breve Descripcion de la Fiebre Amarilla, etc. Madrid, 

1806. 
Assalini: Remarks on the Yellow Fever of 'Cadiz, etc. New 

York, 1806. 
Edinburgh Medical Journal, 1816, vol. 11, pp. 389, 390. 
Halle: Jl. de IMed., Chir., Phar., etc., Paris, 1801, vol. 1, p. 291. 
Dictionaire des Sciences Medicales, Vol. 15, p. 347. 
Jackson, p. 16. ' 

O'Halloran, p.. 17. 
La Roche, vol. 1, pp. 534; 536. 

Pascalis: Medical Repository, New York, 1808, vol. 11, p. 131. 
'S'chousboc; Jl. d. Pract. Arzuk. und Wundarzuk. (Jena und 

Berlin) 1801, vol. 11, p.. 84. 
(Supplement to Madrid Grazette, Tuesday, October 28, 1800. 
Perez: Theses de Paris, 1825, No. 127, p. 13. 
Various official Spanish documents. 



5Si HISTORY OF YELLOW FEVER. 

The Aguila^ which sailed from Havana May 28, 1800, 
stopped at San Lucar de Baranieda (Spain), during the 
last days of June, where the crew dispersed and other 
men were shipped, and reached Cadiz June 30, six days 
after the arriyal of the Dolphin. 

The ship Jupiter^, which cleared from Vera Cruz, Feb- 
ruary 4, 1800, and arrived at Cadiz March 28. A few 
days after her departure from Vera Cruz, one of the 
officers fell ill and died in a few days. Then, one after 
another, all hands on board were taken sick. The condi- 
tion of the ship was at one time so desperate that the 
captain was at one time undecided whether to proceed 
on the voyage or return to Havana. The crew, however, 
made an uneventful recover}^ and the vessel continued on 
her way. 

Eager (loc. cit., p. 16), states that in addition to the 
three vessels which fell under direct suspicion, a large 
number of vessels were continually entering the port from 
trans- Atlantic ports, and that by order of the King, dated 
February 1, 1800, it was absolutely prohibited to submit 
to quarantine any vessel coming from America. Thus all 
safeguards were for a time removed. 

The Wages of Official Corruption. 

The reason why the Dolphin is principally incriminated 
in the infection of Cadiz, is due to the folowing facts, 
narrated by Fellowes (p. 38) : The Board of Health of 
.Cadiz was at the period under discussion, merely a nom- 
inal establishment; health officers were, however, ap- 
pointed, who took the duty by turns weekly. At the time 
the Dolphin arrived in the harbor, a man named Vallialta 
was the Diputado de Sanidad, or m;ember of Health Board, 
was on duty. When the Dolphin was put under observa- 
tion, it was currently reported in Cadiz that money had 
been paid to this peor-^on, which bribe induced him not 
only to give the ship pratique sooner than the time re- 
quired, but to connive at the communication which took 
place with persons from' shore, and particularly with 



SPAIN CADIZ, 1800. 533 

smugglers and others living in Sopranis and Boqueta 
streets. 

The Pre-Epidemiic Cases. 

The first cases were observed early in August, in the 
persons of two health guards who had been on board the 
Dolphin^ and who were taken ill on returning to their 
lodgings in the Barrio de Santa Maria. One died; the 
other recovered. 

Whether imported by the Jupiter, Aguila or the Dol- 
phin, or by the nondescript craft which entered the har- 
bor of Cadiz in 1800, there is no disputing the fact that 
the fever was brought fromi abroad, as yellow fever has 
never originated on Spanish soil. It is also of record that 
the state of the public health of Cadiz was excellent up 
to the beginning of August, when a certain species of 
fever made its appearance in the Barrio de Santa Maria, 
which from the violence and singularity of its symptoms 
and the uncommon rapidity with which its course was 
terminated, attracted the attention of the practitioners 
of the ancient metropolis of Spain. » 

While Do^ctors Wrangled, Cases Multiplied. 

The malady, although at first confined to two streets — 
Boqueta and Sopranis^ — ^in the Barrio de Santa Maria, 
inhabited by sailors and customhouse employes, continued 
daily to gain ground and, in whatever house it appeared, 
every person in the family was attacked. The frequent 
deaths alarmed the magistrates, who, anxious to check 
the evil, asisembled all the practitioners of the town, to 
deliberate on the measures of precautions to be taken; 
but upon this, as upon other similair occasions noted in 
this history, useless discussion arose, each individual 
thinking it incumbent upon himself to do all the talking 
and advance all the theories, with the result that general 
confusion arose and the deliberations led to nothing. The 
prevailing disorder was attributed to all the causes which 
have ever been assigned for the production of fever and 



534 HISTORY OF YELLOW FIVER. 

manT names ^vere given to it. such as STnochal, putrid, 
biliotis. ephemeral, etc. ; in fact, every designation except 
the coiTect one — yeUow fever. 

While the physicians and health authorities of Cadiz 
were wrangling as to its diagnosis, the "mysterious fever" 
was daily gaining gTOund: by the middle of August, the 
number of deaths amounted to twenty or thirty a day. 

The Follies of Superstition and Ignorance. 

On August 20. the news were spread through the Barrio 
de Santa Maiia, that Villialta, the man accused of hav- 
ing permitted tmlawful communications between the Dol- 
phin and the inhabitants of Cadiz, had caught the dis- 
ease and, filled with remorse at the effects which he 
foresaw were. likely to result from his misconduct, refused 
all medical assistance and expired in gi^eat agony. This 
circumstance aroused the suspicion in the public mind 
that the reigning malady was not the common endemic 
of Cadiz, which is obserred nearly every year, and oc- 
casioned so much alaxm amongst the inhabitants of that 
quarter of the town, that on August 23 a mob assembled 
before the house of the Si/ndiro Personero (or head of 
the mtmicipality I and supplicated him to permit them to 
form a procession through the streets, bearing aloft the 
image of Our Savior (Xuestro Padre Jesus \, as a means 
of arresting the progress of the malady. The lower 
classes of Spain are naturally ignorant and superstitious, 
and such was the terror of this fanatic people, that they 
considered themselves the ol>jects of offended Heaven and 
imagined that by following the Cross with htimility, they 
would effectually appease the anger of the Deity. The 
magistrate, dreading this assemblage of persons in a part 
of the town where the disorder was spreading, in vain en- 
deavored to quiet their apprehensions, but all reasoning 
was ineffectual, and the procession took place, passing 

•'A similar procession was held at Aniequera during the 
epidemic of 1804, and was also followed by dire con- 
sequences. See page 505 of this volume. 



SPAIN CADIZ, 1800. 535 

through Sopranis and Boqueta streets, and thence to other 
quarters of the city, whei^e -.the malady had not yetj 
spread. '^^ 

The worst fears of the magistrate were soon realized. 
In a few days, cases of the fever empted in Barrios of 
San Antonio, and on August 27, the pestilence was wide- 
spread. On that day 157 deaths were reported. 

The panic was now at its height and it is recorded that 
13,992 persons fled from the pest-cursed city. 

Desolation. 

Cadiz was now a vast charnel house. It was ordered 
that the dead should be conveyed away in carts and buried 
outside the town ; the ringing of bells was prohibited and 
every measure adopted to tranquilize the minds of the 
people, but the dread of this awful calamity was so 
strongly impresised on every individual, that it seemed 
only to increase the aptitude to take the disease, and many 
instances are recorded of deaths acelerated solely by the 
terror thus induced. 

By the middle of September, the deaths amounted to 
200 daily. All those ■\\^ho could do so, had fled from the 
city. The streets were deserted, the shops, drug-store 
and public places closed, and the air became so vitiated, 
that its noxious state affected even animals and birds. 
Dogs, cats, cattle, etc., were attacked by some disease or 
other, and died by the thousands; canary birds died with 
blood issuing from their bills and even the pugnacious 
sparrow migrated to purer atmospheres. 

The unfortunate inhabitants of Cadiz might have 
mournfully applied to themselves the fallowing lines 
taken from Boucher's immortal poem describing the rav- 
ages of the plague of Marseilles: 

^^Chaque instant voyait hors des murailles, 
S^avancer tout rempli le char des funerailles; 
Sans parens y sans amis, sans pretre, sans flambeau, 
Nulle voix ne suivant se mobile tombeau/^ 



536 HISTORY OF YELLOW FEVER. 

Ajnid this scene of desolation, the most perfect order 
prevailed among those who had remained in the city. 
Although several leading members of the municipal gov- 
ernment had been early carried off by the fever, the popu- 
lace behaved admirably, and none of the disgraceful 
scenes took place which had occurred in other towns of 
the Kingdom during the periods of public calamity. 

A Rift in the Clouds. 

At the time under observation, England and France 
were engaged in one of their periodical disagreements. 
Spain had allied itself with France against the common 
enemy and Johnny Bull sent a fleet to blockade the ports 
of the doughty Castillians. Early in October the British 
fleet under Lord Keith appeared before Cadiz; and this 
novel and startling sight produced an extraordinary ef- 
fect upon the minds of the populace. The fear of an 
attack roused this courageous people to individual ex- 
ertions for their defense, and they swarmed from their 
closed infected houses to repel the invading force. The 
transition from a melancholy contemplation of the spectre 
of pestilence to a state of belligerency against a hated 
enemy, combined with the inception of the cool season, 
seemed to have a magical effect upon the health condi- 
tions of the city. From that date, the disease gradually 
decreased, and by October 30, only 357 cases were under 
treatment and the mortality was unimportant. 

On November 12, the pestilence came at an end and the 
city was officially declared in a state of health by the 
celebration of the Te Deum. 

Total Cases and Deaths. 

Authorities differ as to the exact proportions of cases 
and deaths. The mortality from yellow fever has been 
prodigious in nearly epidemic that has invaded Spain; 
but the precise number of deaths has never been abso- 
lutely correct, owing to the natural demoralized con- 



SPAIN CADIZ. 537 

dition of affairs and the difficulty of obtaining au- 
thentic data. Jackson (loc. cit.^ p. 137), states that it 
may be said with safety that the mortality was not in 
reality less than one-half of those who were attacked. 
The generally accepted figures, so far as the epidemic of 
1800 is concerned, are as follows, {La Roche, vol. 1, p. 
534) : : 

Cases, 48,520; deaths, 10,946. 

Arejula X^^^- cit., p. 256), says that it is a sorrowful 
fact that all the localities in Spain where the disease 
obtained a foothold, owed their misfortunes to the inhabi- 
tants of Cadiz, who fled to them, not with any intention 
of introducing the disorder, but to save their lives by 
taking refuge in places where no disease whatever pre- 
vailed at the time. Thus it happened that the seeds of 
this pestilence were scattered in the neighboring towns, 
such as Puerto de Santa Maria, Isla de Leon, Puerto 
Real, San Lucar and others, causing a total mortality of 
61.363 in the Kingdom."^^ 

1801. 

Another outbreak, but not as mortal as that of the 
previous year, prevailed in Cadiz in 1801. The disease 
was observed principally in a newly-arrived regiment, and 
its spread was not very extensive.'^^ 

1802. 

In the year 1802, five hundred cases were observed in 
Cadiz. These cases all came from ships in the harbor, 
and were transported to the hospital of San Juan de 
Dios by order of Admiral Gravina. The malady did not 
spread to the inhabitants.''"^ 

^^ The detailed mortality in tlie principal cities and towns in 

Spain during the epidemic of 1800, will he found in our 

chronological tables for that year. 
^® Periodico de la Sociedad Medico-Quirirgica de Cadiz, 1822, p. 

23; Berenger-Feraud, p. 70; O'Halloran, p. 177. 
"Dariste: Recherchea Pratiques sur la Fievre Jaune (Paris, 

1825), p. 61. 



538 HISTORY OF YELLOW FEYER. 

1803. 

In 1803, according to Eager, yellow fever spread widely 
in Cadiz and resulted in great loss of life/^ The number 
of fatalities is not stated. 



1804. 



Cadiz was infected by refugees from Malaga in 1804, 
and suffered cruelly. The first case was observed August 
28, and from that date until l^ovember 5, when the epi- 
demic came to an end, 5,000 cases were recorded, of which 
2,892 proved fatal (2,692 males and 200 females). "^^ 

1807. 

After three years of respite, Cadiz again found herself 
threatened with an invasion of yellow fever. The out- 
break was confined to the French squadron in the Bay 
of Cadiz, and did not spread to the shore. ^° 

1808. 

A few cases were imported to Cadiz in 1808, but the 
developments were unimportant.^^ 

1810. 

In. AugTist, 1810, yellow fever was introduced into 
Cadiz by smugglers, and soon attained the proportions 
of an epidemic. Our autthorities {Berenger-Feraudj p. 
83 and Eager, p. 21) do not give any details. 



Eager, p. 18. 

La Roche, vol. 1, p. 536; Fellowes, p. 479. 

Second Report on Quarantine (London, 1852), p. 202, 

Eager, p. 20. 



SPAIN CADIZ. 539 

1811. 

Santa Cruz de Teneriffe, which had been contaminated 
by Cadiz in 1810, infected that city in 1811. The out- 
break was not general. ^^ 

1812. 

Keating^^ claims that yellow fever was epidemic in 
Cadiz in 1812, but we have not been able to substantiate 
the statement. Only a few imported cases were observed. 

1813. 

In 1813 Cadiz was in a flourishiiig condition once more 
and had a, population of 130,000. During the last days 
of July, the w^arship Saint-Pierre^ from Vera Cruz, having 
the vice-roy of Mexico on board, entered the harbor. There 
was no history of yellow fever on board, and the illus- 
trious passenger was received with open arms by the in- 
habitants, and the crew allowed the fredom of the town. 
Shortly afterwards, cases of yellow fever began to appear 
in the richest and most fashionable part of the city, the 
first to be attacked being the nephew of the vice-roy, who 
died a few days after the onset. From this focus, the 
disease radiated to other quarters of the town, finally 
becoming violently epidemic. We have been unable to 
discover the number of cases, but the mortality is said to 
have been 4,000.^^ 

1814. 

Many cases were observed in Cadiz in 1814. Keating 
claims that the disease was epidemic, but no authentic 
records can be found to substantiate the report. ^^ 

*- Berenger-Peraud, p.. 84. 
^^ Keating: History of Yellow Fever, p. 83. 
** Berenger-Feraud, p. 85; Keating, p. 83. 
^^Berenger-Feraud, p. 85; Keating, p. 83. 



540 HISTORY OF YELLOW FEVER. 

1817. 

The famous Spanish physician, Arejula, is quoted by 
Pariset and Eobert^^ as saying that his little daughter 
died of yellow fever in the month of August, 1817. This 
would tend to indicate that the disease was preralent 
that year in Cadiz, but no mention is made in any of the 
works we have consulted, nor in public documents, of any 
other case. Apart from the statement accredited to him 
by Pariset, Arejula himself is silent on the subject. Ber- 
enger-Feraud leans to the belief that the case spoken of 
by Arejula was probably one of malignant icterus and 
not yellow fever. 

The frequent application of the word vomit o preto at 
that period to any dark fluid ejected from the stomach, 
tended no doubt to create obscurity as to the character 
of diseases; and in Spain, medical men, for want of a 
better name, sometimes employed the word fiebre dudosa 
(fever of a doubtful nature) when speaking of an epi- 
demic characterized by febrile manifestations and black 
Tomit. 

1819. 

The great epidemic of yellow fever which devastated 
Cadiz in 1819 has only been equaled in intensity and mor- 
tality by that of 1800. As on previous occasions, unend- 
ing acrimonious discussions arose as to its origin, and 
scores of contradictory theories were formulated. Public 
opinion even went so far as to accuse the warship Sa^i 
Jiiliano. from Calcutta, of having imported the pestil- 
ence; but as the vessel had been on duty at the Philip- 
pines previous to arriving at Calcutta, this contention 
was easily punctured. What placed the San-Jidiano un- 
der suspicion, was the fact that the vessel had scarcely 
begun to load a cargo of cannon powder at Isla de Leon, 
when suspected cases of yellow fever appeared among the 
persons employed on board. The disease also broke out 
in the quarter of the city called Barrio del Christ o^ where 

^Pariset, p. 104; Robert, vol. 1, p.. 88. 



SPAIN CADIZ, 1819. 541 

the baggage of the crew of the San-Juliano had been 
deposited. 

The ship Asia, which arrived in the port from Vera 
Cruz and Havana at about the same time, was also ac- 
cused of having infected Cadiz. This accusation seems 
to us to have been well-founded, for several deaths from 
yellow fever had taken place on board while the Asia 
was in mid-ocean, and the health conditions of the ves- 
sel appeared so unsatisfactory that she was refused pra- 
tique, and the captain ordered to proceed to the quaran- 
tine station at Port Mahon for further observation. The 
fears of the health authorities of Cadiz seem to have been 
well grounded, for three individuals employed in dis- 
charging the cargo at Port Mahon contracted the malady 
and died. 

It is therefore evident that the Asia could easily have 
contaminated the San-Juliano before being sent to Port 
Mahon. It is also of record that passengers from the 
Asia ^^escaped'' during the night while the vessel was in 
the harbor of Cadiz, and went to their homes in the 
Barrio del Ghristo, the locality where the first cases were 
observed. Merchandise Avas also smuggled on shore while 
the guards were ^'looking the other way." 

When news spread that cases of yellow fever had 
broken out in the Barrio del Christ o, the inhabitants were 
greatly alarmed, and at the instigation of a public demon- 
stration, the commandant of the city sent his chief san- 
itary officer, Dr. Flores, to Isla de Leon where the orig- 
inal cases had been observed, to study the disease and 
report on its nature. Dr. Flores, convinced from his in- 
vestigations that the disease was yellow fever, declared 
that rigorous measures alone could avert a disaster. 'But 
his counsels were not listened to. On the contrary, he 
was accused of high treason and held for trial before 
a tribunal of war. The commanding general assured the 
alarmed population that yellow fever did not exist on the 
Isla de Leon, and boastingly added the rather unintel- 
ligible information, that should it enter the city of Cadiz, 
he was prepared to meet it with the point of his sword. 



542 HISTORY OF YELLOW FEVER. 

Notwithstanding all assurances to the contrary, the un- 
heeded warning of the unfortunate Flores came true. The 
scourge struck with frightful force, and among the first 
to run away from the city was the bombastic general. 

The population of Cadiz in 1819 was only 72,000, war 
with France and the unceasing drain upon the Spanish 
cities to maintain peace in the colonial possessions of the 
Kingdom having reduced the male population about one- 
half. The virulence of the fever may be deduced from 
the fact that out of this small population, there resulted 
48,000 cases, of which 5,000 proved mortal.^^ 

1820. 

The following year (1820) a few sporadic cases were 
observed. We can find no record of fresh importa*tion, 
and the first cases no doubt owed their origin to the re- 
awakening of infected mosquitoes which had remained 
inactive during the cool season. 

The first case was a Frenchman, who returned from 
Madrid in February, and who took lodgings in a small 
room where, during the preceding epidemic, two persons 
had died of yellow fever and one had been very ill. At 
the end of May, the new-comer was attacked with the 
diagnostic symptoms of yellow fever. 

The second case was the ordinario of the Bishop of 
Cadiz, who slept in a dark, ill-ventillated room, where in 
the foregoing year, his predecessor had died of yellow 
fe^-er. 

Our source of information^^ does state whether these 
cases proved fatal or not. 

We infer from Dr. O'Halloran's report that the out- 
break was not extensive. Whether the escape of Cadiz 
from an invasion of yellow fever can be attributed to the 

" Berenger-Feraud, p. 89; Eager, p. 21; La Roclie, vol. 1, p. 536. 
^ O'Halloran, p. 177 (foot note) ; Periodico de la Sociedad Medico- 

Quirirgical de Madrid, 1822, p. 23. 
* See histories of the epidemic which ravaged these localities, 

under the proper chapters in this volume. 



SPAIN CADIZ. 543 

inactivity of the Calopae or to the probability that the 
wiclesrpead epidemic of the previous year had left no non- 
immune material, we cannot say. It is one of these in- 
scrutable problems which often confronts the searcher 
after knowledge, and which no amount of reflection can 
elucidate. 

1821. 

The frightful epidemic of 1821 is one of the darkest 
pages in the history of Spain, and nearly depopulated 
Barcelona, Tortosa, Malaga, Asco, Palma and other thriv- 
ing cities of the Kingdom: iCadiz, however, escaped the 
full force of the pestilential wave. There were cases and 
deaths here and there, but the attacks were so limited that 
they scarcely deserve the denomination of an epidemic.^^ 

The origin of the cases observed in Cadiz in 1821 is 
shrouded in mystery. All that is known, is that the first 
persons who suffered, lived in that part of the town in- 
habited by smugglers and the poorer classes, and that 
the first cases erupted in the dwellings of smugglers who 
had "recently arrived from the Bay." From this last 
observation, it' may be logically surmised that the infec- 
tion was contracted on ship-board. 

ConGlusion—lS21 to 1909. 

There is no record of yellow fever having been imported 
to Cadiz since 1821. The awesome fierceness of the epi- 
demic of 1821 in Spain, and the havoc produced in the 
wealth and life of the richest industrial section of the 
peninsula by frequently repeated and devastating pestil- 
ences, attracted the attention of other nations. There 
were accusations of negligence in the enforcement of san- 
itary regulations. This led the Spanish government to 
adopt extraordinary precautions for the prevention of 
future disasters of this character. The leading academies 

«' O'Halloraii, pp. 70; 164. 



544 HISTORY OF YELLOW FEYER. 

and societies of medicine in the Kingdom were interpel- 
lated as to whether yellow fever conld be considered of 
American origin and of an infectious and contagious 
nature. The physicians of Spain, like those of every 
other nation on the globe, when a question is brought up 
for final decision, could not agree when it came to a vote, 
but the majority were convinced of the exotic nature of 
the disease, and that it was ^^infectious and contagious." 
As a consequence, stringent provisions of maritime sanita- 
tion were devised and put into effect, and save the epi- 
demic of El Passajes in 1823 and that of Gibraltar in 
1828, yellow fever ceased to obtain a foothold in Spain 
after the disaster of 1821. 



CANETA DE MAE. 
1821. 



Although only twenty-six miles north of Barcelona, on 
the Mediterranean, Caneta de Mar experienced but a 
single invasion of yellow fever. The facts are as follows :^^ 

During the last days of August, 1821, a young car- 
penter of Caneta de Mar, while seeking employment in 
Barcelona, was hired to do some work on board the ship 
Talla-Piedra. (This vessel, it will be remembered, in- 
fected Barcelona that year and caused a terrible epi- 
demic). He was shortly afterward taken ill and returned 
home, where he arrived on September 5. On the 10th, 
he was a corpse. His mother was attacked on the 12th 
and died on the 15th. The house was hermetically closed 
by the authorities, and no one allowed to enter it until 
the advent of the cold weather, when it was thoroughly 
aerated before any one was permitted to inhabit it. 

No other case erupted in the village. 



Bally, Francois and Pariset, pp. 51; 57. 



SPAIN. 545 

CANETA-LA-REAL. 

1800. 

Refugees from infected localities contaminated Caneta- 
la-Real in 1800. Only a few cases were observed.^^ 

1800 

CARMONA. 

The population of Ca.rmona suffered cruelly during the 
epidemic of 1800, according to Cheryin.^^ 

The number of cases and deaths is not stated. 

1802. 

A few yellow fever patients escaped from the public 
hospitals of Cadiz in 1802„ and sought refuge among 
friends in Carmona. Most of the refugees died, but did 
not contaminate the inhabitants of Carmona. {Pariset, 
p. 79). 

CARRACA. 

1800. 

The disastrous epidemic of 1800 invaded Carraca and 
claimed 515 victims. ^^ The number of cases is not given. 

CARRANA. 

Several writers mention the fact that yellow fever pre- 
vailed at Carrana during the epidemic period in Spain 
(1800-1822), but do not state the year. 



Rougeau: Theses de Paris, 1827, No. 119. 
Chervin: Examen Critique, etc., p. 56. 
La Roche, vol. 1, p. 534. 



5t6 HISTORY OF YELLOW FEVER. 

CAKTAGEXA. 

Yellow Fever Yeaes. 

1753; 1804; 1810; 1811; 1812. 

Summary of Epidemics. 

1753. 

^'Ships of war from America" are said to hscve bronght 
yellow fever to Cartegena in 1753. There was no exten- 
sive spread of the disease.^"* 

1804. 

For over fifty years, we hear of no importation of yel- 
low fever to Cartagena. In 1804, smugglers communi- 
cating with a vessel on which deaths had occurred from 
the disease and which was still in quarantine, brought 
the infection on shore. The first victim was the daughter 
of the Swedish consul, in whose house the smugglers had 
secreted goods surreptitiously taken from the vessel above 
mentioned. A nun who had visited the young girl in 
question and who had been given handkerchiefs to hem 
(these goods having also been smuggled from the same 
vessel), was taken ill \^ith yellow fever and died. Seven 
other nuns living in the same convent rapidly succumbed 
to the disease and the balance fled, the majority carrying 
the germs of the fever with them, and dying in the places 
where they sought refuge. The disease soon made its 
appearance along the principal street of the town, run- 
ning its course from house to house, until it finally in- 
vaded every quarter of the town. 

The population of Cartagena in 1804 was 33,222. From 
September 5, when the first case was observed, to Jan- 
uary 23, 1805, the date of the extinction of the epidemic, 



Eager, p. 16. 



SPAIN CARTAGENA. 54? 

11,445 persons fell victims to the pestilence, of which 
7,630 were males and 3,815 females.^^ 

1810. 

Yellow fever appeared for the third time in the history 
of Cartagena in 1810. Its ravages were considerable, but 
no authentic statipJtics are obtainable.^^ 

1811. 

YelloAv fever reappeared in 1811. The war with France 
militated against the enforcement of preventive measures 
and the disease soon became epidemic and sp'^ead to ad- 
joining cities and towns.^^ 

1812. 

The outbreak of 1812 was not extensive. Lot pfoved 
very fatal. It prevailed principally among the British 
troops stationed in the city. The first unequivocal case 
was that of Major- General Boss, who died with black 
vomit on September 26, at Galleras, a fort situated at the 
summit of a hill on the west side of the town. The in- 
fection rapidly spread to the balance of the troops, and 
by October, over 100 cases were under treatment. On Oc- 
tober 5, about seventy of the worst cases were transported 
on board an improvised hospital ship. Three died the 
evening they arrived on board, two the day following, 
and, in the course of a few days, twenty more fatalities 
were recorded. From October 5 to December 21, when 



Bally, p. 447 

Fellowes, p. 478. 

La Roche, vol. 1, p.. 356. 

Mimaut: Memcire sur la Nature des Maladies Endemiques 3* 

Cartagene (Paris, 1819), p. 47. 
Eager, p, 21; Berenger-Peraud, p. 83; Mimaut, loc. cit. 
BeTenger-Feraud, p. 84»; Eager, p. 21; Mimaut, loc. cit. 



548 HISTORY OF 'i'ELLOW FEVER. 

the epidemic became extinct, all the ^'bad cases'' were 
transiDorted to this yessel. The mortality was heavy.^^ 

Of the prevalence of the fever among the inhabitants 
of Cartagena dtiring this epidemic, the records are verv 
unsatisfactory and no authentic data could be found as 
to the total number of cases and deaths. It is, therefore, 
to be presumed that the malady was confined chiefly to 
the invadinoj armr. 



'O 



CATALAN BAY. 

1813. 

The little Tillage of Catalan Bay (known also by the 
name of La Caleta, and inhabited principallv by fisher- 
men and washerwomen) is located a few miles east of 
Gibraltar. A single case of yellow fever was observed 
there in 1813, in the person of Antonio Perez, aged 28, 
who had gone to Gibraltar on business. On his return 
home, he was taken ill, btit the fact was concealed from 
the inspector. He recovered without contaminating any 
other inhabitant of the village.^^ 

1814. 

In 1811, during the prevalence of yellow fever at Gib- 
raltar, twelve of the inhabitants of Catalan Bay, who had 
visited the former place, were taken ill on their return 
home. Most of those attacked concealed their illness from 
the inspector, from fear of being sent to the Lazaretto, 
and the majority died while pursuing their avocations — 
some in the streets and some in their fishing-smacks. 
Only those who had communicated with Gibraltar con- 
tracted the disease.^^*^ 

^-Proudfoot: Dublin Hospital Reports, 1818, vol. 2, p. 254. Also 
Berenger-Feraud, p. 85: Eager, p. 21; Mimaut. loc. cit. 

*^Documens Recueillis par MM. Cliervin, Louis et Trousseau. 
Paris, 1830, vol. 2, pp. 62; 116. 

^«>Ibid., p. 120. 



SPAIN. 549 

1828. 

The virulent epidemic of yellow fever which made 
1,677 victims in Gibraltar in 1828, was introduced into 
Catalan Bay by a water-carrier, whose occupation com- 
pelled him to make daily pilgrimages to the city. This 
man, taken isick about September 18. died on the 23rd. 
His family consisted of his wife and four children. Two 
of the children were next attacked, then the mother and 
then the remaining children. Aill but one boy followed 
the unfortunate water-carrier to the grave. 

From this focus, the disease radiated in every direction, 
and hardly an inhabitant of the hamlet escaped an 
attack.101 

CHICLANA. 

1800. 

Like the balance of the towns in Southern Spain, Chic- 
lana was invaded by the "yellow pestilence" in 1800. 
Out of a population of 10,000, 1,328 died: {Lw Roche, 
voLl,p,5U), 

1819. 

The widespread epidemic of 1819 spread to Chiclana 
and caused much mortality. (Berenger-Feraud, p. 90), 

CHIPIONA. : 

At some time or other, during the epidemics which 
desolated Spain from: 1800 to 1828, Chipiona suffered 
from yellow fever, but the authors we have consulted do 
not state the exact date. (See the vague and unsatis- 
factory accounts given by Chervin, Pariset, Bally and 
other ancients who have discussed at length the great 
epidemics of yellow fever in Spain). 

""^Ibid., p. 2; Berenger-Feraud, p. 106. 



550 HISTORY OF YELLOW FEVER. 

CHURKIANA. 

1800. 

Churriana, suburb of Malaga was, in 1800^ a separate 
cominiunity, inhabited principally by bakers, who sup- 
plied the metropolis with bread. Only one case was ob- 
served in the village that year, in the person of the wife 
of a baker, who recovered. ^^^ 



1804. 



In 1804, yellow fever committed fearful ravages in 
Malaga. ^^^ Thirty- two inhabitants of Churriana,, who 
had brought bread and other provisions to Malaga, re- 
turned home with the disease in their system and died. 
The disease did not spread, only those who had communi- 
cated with the seat of infection falling victims to the 
pestilence.^^^ 

CIEZA. 

{See Zieza). 
COIN. 

' 1804. 

Refugees from Malaga infected Coin in 1804. The dis. 
ease did not spread to the inhabitants of the village, being 
confined to the imported cases.^^^ 



"- Chervin, Bxamen Critique, p. 52, 
"^ See Malaga, year 1804. 
"^Dariste, p. 62; Fellowes, pp.. 181; 185. 
105 Fellowes, p. 181. 



SPAIN. 551 

CONIL. 

1800-1821. 

Chervin^^^ states that between the years 1800 and 1821, 
inclusive, 172 persons affected with yellow fever came to 
Conil from Cadiz and other infected localities, but in no 
instance was the infection transmitted to the residents 
of the village. pMost of the cases proved fatal. 

COEDOVA. 

1800. 

lA few fugitives from' Cadiz were treated in an isolated 
section of the Cordova general hospital in 1800. There 
was no spread of the malady. ^^'^ 

1802. 

In 1802, five hundred cases of yellow fever were sent 
from vessels in the harbor to the public hospital of Cadiz. 
A few patients escaped to Cordova and other localities. 
There was no diffusion of the malady.^^^ 

1804. 

The only epidemic of yellow fever in Cordova, of which 
there is any record, took place in 1804. The population 
was then 40,000. The first case came from Malaga and 
erupted September 28. From that period until November 
14, the date of the last case, there were 400 deaths, of 
which 180 were males and 220 females.^^^ It is worthy 
of note that this is one of the few epidemics of 

^°^ Chervin : Examen Critique, 2^. 54; Rcugeau, Theses de Paris, 

1827, No. 119. 
^'' Bally, p. 74. 
^°« Pariset, p.. 79. 
"Tellowes, p. 478; Chervin, Examen Critique, p. 3. 



552 HISTORY OF YELLOW FEVER. 

yellow fever in Spain in which the mortality was greater 
among women than men. 

COEIA. 

1800. 

Coria, six miles south of Seville, was contaminated by 
the latter in 1800. Mortality, 450.1^^ 

CORTES DE la: FEONTERA. 

/ 1800. 

During the general epidemic of 1800, refugees from in- 
fected points brought yellow fever to Cortes de la Fron- 
tera. The infection did not spread to the inhabitants of 
the village. ^^^ 

CORUNNA. 

1803; 1822. 

Corrunna, the northwesternmost port of Spain, was 
threatened with invasions of yellow fever in 1803 and 
1822. Energetic sanitary measures were immediately 
taken in both instances and the disease confined to im- 
ported cases. (Pariset, p. 96). 

DOS HERMANAS. 

1800. 

Seville contaminated Dos Hermanas in 1800. The mor* 
tality amounted to 70, all refugees.^^^ 



"'^ La Roche, vol. 1, p. 534. 

"^Rougeau, Theses de Paris, 1827, No. 119. 

^" La Roche, vol. 1, p. 534. 



SPAIN ECIJA. 553 

EOIJA. 

1800. 

Ecija, fifty-two miles northeast of Seville, on the Genii 
Kiver, is a point of mnch interest to the tourist, on ac- 
count of its ancient Eoman ruins and fine sheltered prom- 
enades, but it is so hot as to be called "the frying pan 
of Andalusia.'^ 

Ecija has been invaded by yellow fever on three occa- 
sions only, two epidemics (1800 and 1804) and o-ne im- 
portation (1802). The present population of the town 
(about 30,000) does not show that much progress has 
been made in this direction, as there were 40,000 souls 
within its walls in 1800. 

Ecija was contaminated by Seville in 1800. Profiting 
by the terrible experiences of that unfortunate city of 
Cadiz, stringent sanitary measures were instituted, and 
the disease limited to 400 cases, of which 100 died.^^'^ 

1802. 

According to Pariset (page 79), a few cases of yellow 
fever were observed in Ecija in 1802. The disease was- 
confined to the importations. 

1804. 

In 1804, the population of Ecija was about the same as 
in 1800. On October 8, the first unequivocal case of yel- 
low fever was reported, and by the 31st of the month, the 
epidemic was widespread. The fever raged until Decem- 
ber 20, resulting in 5,000 cases, of which 3,802 proved 
fatal. * This is another of the few examples where the 
mortality was higher among women than men, the figures 
being 2,i22 for the former, against 1,380 for the latter.^^^ 

"3 Bally, p. 75; La Roche, voL 1, p. 536. 

"*La Roche, vol. 1, p. 536: Fellowes, p. 478; Chervin, Examen. 
etc., p. 8. 



554 HISTORY OF YELLOW FEVER. 

EL AEAHAL. 

(See Arahal). 

EL BORGE. 

1804. 

The village of El Borge was contaminated in 1804 by 
persons fleeing from Malaga, and lost the greater part of 
its population. ^^^ The number of cases and deaths is not 
stated. 

EL PALO. 

1804. 

El Palo, infected by Malaga in 1804, suffered cruelly 
from yellow fever. "All of the inhabitants were attacked 
with the epidemic, and it occasioned great destruction 
among them."^^^ 

EL PASSAJES. 

{See Passajes). 

EPREZALENA. 

1800. 

In common with other towns within the radius of in- 
fection, Esprazalena was invaded by the Saffron Scourge 
in 1800. The mortality was inconsequential. ^^^ 



^•'' Pellowes, p. 186. 
^"Fellowes, p. 186. 
'^ Rougeau, loc. cit. 



SPAIN ESPEJO 555 

ESPEJO. 

1803. 

Refugees from Malaga brought yellow fever to Espejo 
in 1803. The outbreak was not extensive. ^^^ 

1804. 

The terrible yellow fever epidemic of the year 1804, 
which prevailed at various sea coast towns of Spain, is 
said to have made its way into Espejo in the following 
manner :^^^ 

John Cordoba, a muleteer, arrived from Malaga about 
five in the evening of the 27th of August, much indis- 
posed. He sent for one of the physicians of the place, 
who finding the case to be alarming, reported the circum- 
stances to the health authorities. Cordoba was himi-self 
Impressed with the idea that he was infected with the 
plague or epidemic. He had brushed, in passing through 
the streets, one of the carts employed to cari'y the dead 
to the grave. His imagination was struck ; and, conceiv- 
ing that touch was sufficient to communicate the mal- 
ady, he believed the incident alluded to, to be the actual 
cause of the indisposition which he then felt. Various 
persons from the adjoining houses visited Cordoba in his 
illness, some in friendship,, others to purchase things 
which he had brought from Malaga for sale. 

When news of Cordoba's illness reached the author- 
ities, the patient was at once carried to the open country, 

"^ Berenger-Peraud, p.. 75. 

"'Jackson: Yellow Fever on the South Coasts of Spain, p. 23; 
Fellowes, p.. 478; Bailly, p. 90; Eager, p. 20. 

* Fellowes gives the following figures: Males, 100; females, 268. 
' This would give a total of 368. Both Fellowes and Bally- 
state that the total deaths were 329. It is a noteworthy 
fact that the mortality among men has in nearly every 
instance been greater than among women during the 
epidemics of Andalusia and we have taken the liberty of 
adding the missing figures to the male column.. 



55 6 HISTORY OF YELLOW FEVER. 

and the remaining goods he had brought from Malaga 
de^troTed. But it Tvas too* late. The seeds of infection 
were already sown. All those who had visited the mule- 
teer during his illness, were taken ill with yellow fever 
and a majority died. The disease manifested itself at 
first to the portion of the city frequented by the friends 
of Cordoba. A rigorous cordon was instituted and thus 
the other sections of the city were spared. 

Espejo had a population of 4.961 in 1S04. From August 
27 to November 25. the date of the last death, there were 
329 fatalities from the fever. Of this number, 161 were 
males and 168 females. 

ESPERA. 

1800. 

In ISOO. yellow fever invaded Espera and caused a mor- 

talitv nf 112. The infection undoubtedlv came from 
Cadiz.120 

1801. 

The population of Espera in ISOl was 2.0S1. The first 
case of yellow fever was observed September 25: the last, 
December 3. During the course of the epidemic, there 
were 139 deaths, of which 2.S0 were males and 159 
females.^-^ 

ESTEPA. 

1800. 

A single instance of yellow fever having invaded Estepa 
is recorded. During the general epidemic of 1800. ref- 
ugees fled to this village. In spite of the fact that the 
scourge was committincr fearftil ravages in nearly every 
city and town in Andaltisia. only two persons died of the 
disease in Estepa. (La Boche, vol. 1, p. 534). 

^ La Roche, vol. 1, p. 534. 
""^Fellowes, p. 4TS. 



SPAIN. 557 

FEEKOL. 

1858. 

Ferrol, twelve miles nortlieast of Corunna, was con- 
fronted with a small epidemic of yellow fever in 1858. 
On July 30 of that year, the warship Isabel II entered 
the port. She had originally sailed from Havana in the 
last days of May, and had stopped at Gijon, a port in 
ilie Bay of Biscay, before coming to Ferrol. On July 
31, the day after her arrival, a sailor named Pablo Bor- 
reli, who had been ailing for several days, was transferred 
from the vessel to the military hospital, where he died 
of yellow fever on August 1. On August 8, three more 
sailors from the Isabel II died from the same disease 
at the hospital. Nine cases in all were admitted to 
the hospital. Our source of information does not state 
whether or not there were any further fatalities. The 
disease did not spread to the inhabitants of Ferrol. ^^^ 

FKAGA. 

1821. 

'Refugees with the poison of yellow fever in their system; 
fled to Fraga in 1804, and a majority died. The inhabi- 
tants of the village were not contaminated.^^^ 

GIBRALTAR. 

Yellow Fever Years. 

1649; 1727; 1798; 1800; 1803; 1804; 1810; 1811; 1813; 
1814; 1818; 1822; 1824; 1825; 1826; 1828; 1829. 



Capriles: Siglo Medico, Madrid, 1858, vol. 5, p. 284; Vizalde; 

llDid, pp. 263, 282. 
Bally, Francois and Pariset, p. 62, 



558 HISTORY OF YELLOW FEVER. 

Historical Eesume. 

Gibraltar, known to the Greeks as Calpe, was first for- 
tified as a strategic point by the Saracen leader, Tarik 
Ibu Zeiad, in 711-712, from whom it was thenceforward 
called Gebel-al-Tarik, the rock of Tarik. It was ulti- 
mately taken by the Spaniards from the Moors in 1462, 
fortified in the European style, and so much strengthened 
that the engineers of the seventeenth century considered 
it impregnable. It was taken, however, after a vigorous 
bombardment in 1704 by a combined English and Dutch 
force under Sir George Rooke and Prince George of 
Darmstadt, and was secured to Britain by the Peace of 
Utrecht in 1713. Since then it has remained in British 
hands, notwithstanding many desperate efforts on the part 
of Spain and France to retake it. 

Vast sums of money and an immense amount of labor 
have been spent by England in fortifying this celebrated 
stronghold, which, in case of war, would form one of the 
most important points of support for naval operations. 
Numerous caverns and galeries, extending two to three 
miles in length, and of sufficient width for carriages, have 
been cut in the solid rock, with port-holes at intervals of 
every twelve yards, bearing upon the neutral ground 
which separates the fortress from the mainland and the 
Bay of Gibraltar, and mounted with more than 1,000 
guns, some of them of the largest size. The regular gar- 
rison in time of peace is 5,000. 

Summary of Epidemics. 

1649. 

Historians assert that yellow fever had never been ob^ 
served at Gibraltar prior to 1803, but ancient documents 
and Spanish tradition give vague, but undoubtedly au- 
thentic accounts of the prevalence of the disease among the 
Spanish garrison, as far back as the middle of the seven- 
teenth century. 



SPAIN GIBRALTAR. 559 

According to the Second Report on Quarantine^ pub- 
lished by the General Board of Health of Great Britain 
in 1852 (page 153), a Dr. Morillo, who had been eniiployed 
at Marabella and other towns in Andalusia during a pes- 
tilential outbreak (the nature of which is not stated), 
went also to Gibraltar, to investigate an epidemic, which, 
according to an old history of Gibraltar by Ayola, proved 
so fatal, that the people, losing all confidence in human 
means, instituted processions to the neighboring hermit- 
age of San Eoque, which were kept up annually in the 
month of August, till the surrender of the garrison to 
the British in 1704. 

Although we have been unable to find any record of 
Dr. Morillo's report (if any was ever made), we have 
no doubt that this epidemic was one of yellow fever. 

1727. 

There is a record that the garrison at Gibraltar lost 
500 men by fever in 1727, twenty-three years after the 
fortress had been taken by the British. The character of 
the disease is not described, but the excessive mortality 
leaves no doubt that it was yellow fever.^^^ 

1798. 

Another outbreak of yellow fever on this celebrated 
rock, not mentioned in the various works on epidemiology 
we have consulted, is said to have taken place in 1798. 
This information is contained in a letter written Staff- 
Surgeon Hill, of the British Army, dated June 13, 1832, 
and published in the Second Report on Quarantine. 

It appears from said letter that the 48th Kegiment 
having returned from! the West Indies a complete skele- 
ton, were completed by recruits from the different sup- 
plementary corps to the number of 1,100 strong, with 
which it immediately embarked on board the Calcutta 
Indiaman, September 1, 1798, at Lymington, England, 
and arrived at Gibraltar the following month (October) ; 

"* (Second Report on Quarantine, p. 153. 



560 HISTORY OF YELLOW FEVER. 

previouslT to the regiment embarking there had been a 
detachment on board, and two or three cases of small-pox 
occurred; the ship had been fumigated and whitewashed, 
but, nevertheless, a few cases of small-pox were debarked 
.at Gibraltar on the arrival of the regiment at that 
foirtress; in all other respects the men were liealthy, al- 
though muC-h crowded on board ship, and such was the 
state of equipment that the men appeared in their dif- 
ferent county militia uniforms, not having had time to fit 
on the proper uniform clothing prior to leaving England. 

Soon after the arrival of the corps at Gibraltar, several 
cases of vellow or bilious remittent fever made their ap- 
pearance, which increased rapidly and proved highly fatal. 
Dr. Harness, physician to Lord St. Vincent's fleet de- 
clared the fever was precisely the same he had seen in the 
West Indies, and requiring the same treatment. 

The young recruits were the only sufferers, not an of- 
ficer being attacked. Most of the latter had lately re- 
turned from the West Indies, but among the stibalterns 
there were several that had never before been out of 
England. 

The total mortality amounted to 100. The number of 
cases is not stated.^--^ 

The fact that the 48th Regiment came from the West 
Indies, a notorious hot-bed of yellow fever, and the high 
rate of mortality, leaves no hesitation in our mind that 
the disease under discussion was yellow fever. 

1800. 

In Trotter's Medicina 'Nautica, it is stated that 257 
deaths from ^'fever-' took place at Gibraltar in 1800, 
among the military. ^-^ 

Although the word ^'yellow fever'' is not mentioned by 
this authority, the fact that this disease was general in 
Spain in 1800, and that the average yearly mortality dur- 
ing non-epidemic periods among the military had been 
only thirty-eight, is conclusive proof that the Antillean 
Pestilence prevailed at Gibraltar that year. 

^Second Report, etc., pp. 153; 206, 
^ Second Report, etc., p. 153. 



SPAIN GIBRALTAR. 561 

1803. 

We now come to the first authentic invasion of Gib- 
raltar by yellow fever. During the summer months 
(presumably August), smugglers brought the disease to 
to the town. Only a few sporadic cases resulted.^^^ 

1804. 

A reference to our chronology will show that yellow 
fever was widespread in Andalusian in 1804. A rigorous 
cordon was placed in the environs of Gibraltar, but smug- 
glers from Cadiz and Malaga succeeded in eluding the 
vigilance of the coast-guards, and stole into the place. 
That they carried something more harmful to public in- 
terests than contraband goods is obvious from the sequel. 
Some of them developed yellow fever in the midst of the 
healthy population of Gibraltar and died, diffusing the 
infection among the inhabitants.^^^ 

The population of Gibraltar in 1804 (both civil and 
military) was 15,000. When the epidemic came to an end, 
5,733 fatalities had occurred, 4,864 among the civilians 
and 869 among the military. ^^9 i 

1810. 

Sporadic cases appeared in 1810, causing a mortality 
of seventeen among the civilians and six among the 
soldiers. ^^^ 

1811. 

Gibraltar was infected by Cadiz in 1811. Beyond the 
miere mention of this fact, our authority^^^ gives no in- 
formation of any value. 

"' Berenger-Feraud, p. 74. 

^^ Eager, p. 19. 

"^Second Report on Quarantine, p. 158. 

^^° Second Report on Quarantine, p. 158. 

"^ Berenger-Feraud, p. 84. ^ 



562 HISTORY OF YKLLOW FIVER. 

1813. 

The warship St. Pierre brought yellow fever to Cadiz 
in 1813. On August 11 of that year a vessel called the 
Fortune arrived at Gibraltar from Cadiz. One of the 
crew being ill, was sent to the Catholic Hospital, and 
died on the 19th of the same month, with every symptom 
of yellow fever. Nothing untoward happened until the 
end of the month, when a Frenchman, a native of Paris, 
residing in Government Street, near City Hall Lane, was 
taken ill with the same symptoms as the first case, and 
died on September 3. It afterwards developed that this 
man had been a passenger on board the Fortune, and had 
landed the same day as the sailor who died on August 19th. 

Between the 3rd and 11th days of September, nine per- 
sons died of yellow fever in the same neighborhood. The 
disease spread to other streets and the entire town was 
soon infected. 

The total number of cases and deaths was as follows : 

Cases. Deaths. 

At Lazaaretto 635 281 

In town 684 218 

At Military Hospital 1,470 384 



2,789 .883 

Among the deaths at the Military Hospital, were 
twenty-four ofl&cers, fifty-eight soldiers' wives and six 
children.^^^ 

1814. 

The epidemic of 1814 lasted from August to November, 
and claimed the following victims.^^^ 

Civilians 132 

Soldiers .....114 



246 



^^^Gilipin: Medico-Chirurgical Transactions, London, 1814, vol. 5, 

pp. 328, 338. 
^^^ Second Report on Quarantine, p. 159. 



SPAIN GIBRALTAR. 563 

1818. 

In the month of August, 1818, a solitary case of yellow 
fever, followed by recovery, was observed at Gibraltar.^^* 

1822. 

Two cases of yellow fever are recorded for the year 
1822. They were observed in September.^^^ 

1824. 

Gillkrest, surgeon of the 43rd Light Infantry, reports 
having attended two cases of yellow fever at Gibraltar in 
1824.* One of the cases was that of a private, whom the 
doetor attended, until, in the course of his ministrations, 
he was himself taken ill, furnishing the second case.^^^ 



^^*Amiel: Second Report on Quarantine, p.. 266. 

"^Amiel, loc. cit. 

* As the main object of the researches made iby the compilers 
of the Second iReiport on Quarantine was to uphold the 
theory that yellow fever was not always imported to 
Gibraltar, but could originate on Spanish soil when certain 
climatic and atmospheric conditions were present, the 
eminent physicians who conducted the examinations em- 
bodied in the Report evidently took advantage of every 
honest opportunity to amass evidence to fortify their 
pretensions. We theirefore think that the evidence they 
gathered regarding the prevalence of sporadic cases in 
certain years genuine, nothwithstanding adverse criticism 
by numerous authors. Of course, the opinion that the 
disease originated on Spanish soil is absurd, our present 
. day knowledge leading to the belief that the sporadic 
cases noted in this history owed theiir origin simply to 
the renewed activity of infected Calopae. Why the 
disease did not propagate in those special instances, is 
one of these mysteries which Nature veils from human 
ken and which no amount of reasoning, however deep or 
methodical, can satisfactorily explain. 

"'Gillkrest: Second Report on Quarantine, p. 266. 



564 HISTORY OF YELLOW FEVER. 

Dr. Gillkrest was attended by Dr. Arejula, physician to 
the King of Spain, who has written learnedly on the 
epidemics of Andalusia. 

1825. 

In Xovember, 1825, two s^Doradic cases of yellow feVer 
are said to have erupted in Gibraltar. This is the first 
time on record where fellow fever showed itself so late 
in the year in this locality. Our informant does not fur- 
nish any details. 

1826. 

Three cases, a soldier and two civilians, were observed 
in 1826. One of the civilians died.^^^ 

1828. 

A severe visitation of ^'ellow fever ravaged Gibraltar 
in 1828. The history of this epidemic is related at length 
by Messrs. Chervin, Louis and Trousseau, in a work re- 
markable for the vast amount of documentary evidence 
which these gentlemen amassed, but which is tmfortun- 
ately so unwisely classified, that it takes a vast amount 
of dessication to separate the wheat from the chaff, and 
therefore greatly detracts from the importance of the 
work as one of ready reference. After laboriously going 
over the 512 documents, covering two vohimes of 412 
pages each, one is finally able to condense the following 
information : 

The Swedish ship Djfgden left Havana May 12, 1828, 
with a crew of 16. The vessel reached Gibraltar June 
28. Two sailors had died from yellow fever during the 
voyage, one on May 27 and the other June 1, The Dygden 

^'^Amiel, loe. eit. 

'** Browne and Gillice: Second Report on Quarantine, p. 266. 

^^Dccumens Recueillis par MM. Chervin, Louis et Trousseau, 
Members de la Commis3ion Francaise Envoyee a Gibraltar 
pour Observer rEpidem:'e de 1828; et psr M. le Dr. Barry, 
Medecin des Armees Anglaises. 2 vols., Paris 1830. 



SPAIN GIBRALTAR. 565 

was deemed so unsanitary that pratique was refused tlie 
captain, and the vessel ordered to quarantine, where she 
remained forty days. Although presumably under strict 
surveillance, it was only on July 27, or 29 days after her 
arrival, that health-guards were sent on board. The ship 
was released from quarantine August 8. 

The first cases of yellow fever on shore erupted August 
29, in the house of a man named Testa, one of the guards 
sent on board the Bygden on July 27. Much stress is 
laid on this fact by the historians of this epidemic, and 
Testa is accused of having infected his sister, who was the 
first person to die of the disease, but as Testa himself did 
not have the malady at the time and the germs are not 
spread by contact, infected mosquitoes were no doubt 
introduced into the premises, probably in smuggled goods, 
and thus a focus was created. Of course, our astute 
friends of over a century ago had no idea of the mos- 
quito transmission of yellow fever, and the fact that Testa 
had been on board the Dygden and his sister was the first 
person stricken, was strong enough evidence to place the 
burden of contagion on the shoulders of the unfortunate 
health-guard. 

Another vessel, the Meta, is also accused of having con- 
taminated the town in 1828. This ship left Havana at 
about the same date as the Dygden, and arrived at Gib- 
raltar at the end of June, having lost two men from yel- 
low fever during the voyage. She was submitted to a 
quaranatine of twenty-one days. Contraband goods found 
their way on shore, and the vessel was also visited by 
washerwomen from Gibraltar and the neighboring vil- 
lage of Catalan Bay, who took the soiled linen of the 
sailors to their homes. Most of the washerwomen con- 
tracted yellow fever and died. \ The chroniclers of the 
period attributed their death to the fact that among the 
clothes taken by them from the Meta, were some which 
had belonged to the sailors who had died during the voy- 
age, and which were still soiled with black vomit. 

Whether contaminated by the Dygden or the Meta, or 
by both, it is plain, from a summary of the evidence, that 
Havana was the original source of infection. Such has 



566 HISTORY OF YELLOW EEYER. 

generally been the case in nearly every epidemic of yel- 
low fever in Spain. 

The last death occurred December 25. With the ex- 
ception of the disastrous epidemic of 1804, that of 1828 
proved to be the worst that Gibraltar ever experienced. 
There were 5,543 cases, of which 1,677 proved fatal. The 
mortality among the civil population amounted to 1,170, 
while the military, out of a population of 3,781, lost 507. 

1829. 

A few cases and deaths are recorded for the month of 
January, 1829, being the "tail end" of the epidemic of 
the year previous. The last death occurred on the 14th 
of the month. 

Since 1829, yellow fever has not been observed at 
Gibraltar. 

GRANADA. 

1804. 

The beautiful and historic city of Granada was visited 
by yellow fever once in its history. On August 25, 1804, 
the first case was observed, and the disease slowly pro- 
pagated itself, resulting in a total of 306 deaths, out of 
a population of 54,962. The mortality among the males 
was 185 ; females, 121. The epidemic exerted its greatest 
intensity on October 10, and became extinct on the 28th 
of the same month.^^^ 

GUARDAMAR. 

1804. 

Yellow fever was brought to Guardamar by refugees 
from Alicante and other infected places in 1804, but did 
not spread to the inhabitants. Out of a population of 

^^^ Second Report on Quarantine, p. 159. 
"^Fellowes, p. 478, 



SPAIN GUARDAMAR. 567 

2,464, not a single case occurred among the inhabitants. 
Only fourteen deaths are recorded, the first, September 
21, and the last, November 16. The mortality among the 
men was eight; women, 6.^^^ The absence or inactivity 
of the Calopae no doubt saved Guardamar from a dis- 
astrous epidemic. 

HUELVA. 

1800. 

A few cases of yellow fever were brought b;y refugees 
to Huelva in 1800, according to Rougeau.^^^ The devel- 
opments must have been unimportant, as we find no de- 
tailed history of the incident in any works on epidem- 
iology. 

ISLA DE LEON. 

Isla de Leon (also know as San Fernando) is only seven 
miles from Cadiz, and it is surprising that yellow fever 
has not been observed there more frequently than on the 
three occasions mentioned in this history. 

1800. 

In 1800, Isla de Leon was infected by refugees from 
Cadiz. The town had then a population of 32,000. In 
less than three months, 5,033 of its inhabitants fell vic- 
tims to the terrible pestilence.^^^ 

1811. 
In 1811 yellow fever was imported to Isla de Leon by 
a vessel from Santa Cruz de Teneriffe, and claimed many 
victims. ^^^ From this focus, the disease spread to Cadiz, 
Gibraltar and Alicahte. 

"^Fellowes, p. 478.. 

"^Rougeau: Theses de Paris, 1827, No. 119. 

^" La Roche, vol. 1, p. 534. 

"^ Berenger-Feraud, p. 84. 



568 HISTORY OF YELLOW FEVER. 

1819. 

The steamship Asia, from Vera Cruz and Havana, in- 
fected Isla de Leon in 1819.^^^ From this focus, the 
neighboring city of Cadiz was contaminated and experi- 
enced one of the m|ost dismal epidemics in its history. 

JESUS. 

1821. 

Fugitives from Tortosa brought yellow fever to the vil- 
lage of Jesus, on the Ebro, opposite that city, in 1821. 
A man named Cordoba and his dauaghter, who had com- 
municated with Tortosa, contracted the disease and died, 
without contaminating other inhabitants of Jesus. Dur- 
ing the progress of the epidemic at Tortosa, several per- 
sons who had fled to the village died, but in no instance 
did the malady spread. ^^^ 

JUMILLA. 

1811. 

A few cases of yellow fever were observed at Jumilla, 
thirty-seven miles northwest of Murcia, in 1811. There 
was no spread of the disease. ^^^ 

1812. 

The battle of Salamanca (July 22, 1812), which stopped 
the progress of the victorious French army through Spain, 
compelled General Marmon to abandon his plans of fur- 
ther conquest and retrace his steps. During the month 



"« Begin: Journal de Medecine Militaire, 1820, vol. 7, p. 346. 

Also: Berenger-Feraud, p. 89. 
"^ O'Halloran, p. 121. 
"® Bally, Francois and Pariset, p. 560. 



SPAIN JUMILLA. 56& 

of September, 1812, a portion of this once splendid corps 
traversed the Kingdom of Murcia. A division arrived 
on October 1, at Zieza, a small town on the Segura, 
where j^ellow fever was epidemic, having been imported 
by two individuals from Cartagena during the early days 
of September. Nearly all the inhabitants of Zieza had 
fled from the threatened pestilence, and the troops finding 
only deserted houses and rottening corpses, pressed north- 
ward. Two days later, the soldiers arrived at Jumilla, 
which had already been contaminated by Zieza, but where 
conditions were better, and decided to rest from their 
fatigues. A few days later (October 8), a soldier was 
taken ill with the prevailing fever and died in forty-eight 
hours. From that date to the 28th of the moath, the dis- 
ease spread through the camp and claimed about 100 vic- 
tims. The segregation of the soldiers finally put an end 
to the epidemic.^^^ 

LA CAKLOTA. 

1800. 

The beautiful little town of La Carlota, seventeen miles 
southwest of Cordova, had a population of 733 in 1800. 
Refugees from Cadiz brought yellow fever to the place 
that year. When the first cases erupted, all those who 
could do so fled, the remaining population being 473, 
Out of this small number, there resulted 195 cases, 122 
of which proved fatal.^^^ 

This is the only authentic record of the appearance of 
yellow fever at La Carlotta. 

LA EAMBLA. 

1803. 

La Rambla, which had been spared during the wide- 
spread epidemic of 1800, was contaminated by refugees 

"^Pessou: Journal de Medecine Militaire, 181, vol. 5. p. 304. 
^^<* Bally, p. 74. 



570 HISTORY OF YELLOW FEVER. 

from Malaga in 1803, and suffered severelj.^'^^ Our au- 
thority fails to give any details. 

1804. 

In 1804 yellow fever was introduced into La Eambla 
from Malaga in the following manner :^^- 

A man by the name of Nieto, who had been at Malaga 
on business, was prompted by morbid curiosity to follow 
and touch a burying-cart containing the corpse of a person 
that had died of yellow fever. ;0f course, the mere fact 
that he did this was certainly not sufficient to infect him, 
but the incident is mentioned to illustrate the peculiar 
views of contagion held by the physicians of the period. 

Even Jackson, who lived in an atmospheie of rabid 
contagionists and infectionists, ridicules the idea. "It 
is known by experience,'' observes the doctor, "that neither 
burying-carts nor dead bodies possess the material of con- 
tagion in a condition to communicate the infection to 
others; the whole has the air of a story, the blanks of 
which are filled up by fiction — the facility of doing which 
seems to be characteristic of the Spanish nation.''^^^ 

In whatever manner Nieto contracted the disease, it is 
certain that he brought it to La Eambla. He went to 
bed immediately on his arrival home, on the day in ques- 
tion. He was not seriously ill and recovered. A youth 
named de Castro who lived near I^ieto, and who visited 
him during his illness, was taken ill on the 9th of Sep- 
tember and died on the 16th. A young woman, Maria 
Marina Do bias, a cousin of Nieto, who lived in a house 
contiguous to his, came to see him during his illness and 
was attacked by the disease. Christobal Dobias, who oc- 
cupied the same house with Maria, was taken ill about 
the same time as the woman, and died on the 19th of 
September. Garcia Luque, bridegroom of Maria, was 
taken ill about the same time as his wife, and also died 

"^Berenger-Feraud, p. 74. 

"^Arejula: Breve Descripcion de la Fiebre Amarilla Padecida 

en Cadiz, etc., p.. 286. 
*^» Jackson, p. 21. 



SPAIN LA RAMBLA. 5?! 

on the 19th. Garcia Luque lived in a distant part of the 
town where there was as yet no sickness, and no doubt 
contracted the malady when he came to live with his 
father-in-law. Luqne's mother was attacked about a 
month after the death of her son. 

La Rambla had a population of 6,000 in 1800. The 
disease made slow progress, and finally came to an end 
in the early days of October. Only seventy cases, of which 
thirty-seven proved fatal, are recorded. 

LAS AGUILAS. 

(See Aguilas). 

LAS CAVEZAS DE SAN JUAN. 

1800. 

Yellow fever invaded Las Cavezas de San Juan in 1800 
and, according to La Roche,^^^ caused a mortality of 994. 

LAS PALACIOS. 

1800. 

Las Palacious experienced a solitary invasion of yellow 
fever. According to La Eoche, 192 fatalities resulted in 
1800. No other details are given.^^^ 

LEBRIXA. 

1800. 

In the year 1800 the people of Lebrixa suffered from 
yellow fever, in consequence of being infected by a cavalry 
regiment from Alcantara, which, proceeding from places 
where the malady was prevailing, passed a night in the 



^=**La Roche, vol. 1, p. 534. 
^='La Roche, vol. 1, p. 534.. 



57i HISTORY OF YELLOW FEYER. 

town and left some sick. The fever spread after the de- 
parture of the regiment and attacked progressiyelT the 
inhabitants, causing such havoc that ^'numbers of them 
could not obtain professional aid or attendance for this 
malignant and fatal disease.-' (O-Haaloran, p. 153). 
According to La Eoche, 2,100 persons were carried off by 
the epidemic. ^^^ 

1811. 

A few cases were observed in 1811. The local Board 
of Health inaugairated strict sanitary measures and in- 
creased its vigilance, cutting off every communication 
with infected localities, and the disease was confined to 
the imported cases. ^^' 

1821. 

The first case of yellow fever in Lebrixa in 1821, ap- 
peared in the person of Simon Eiega, who resided in the 
Posada Xueva de la Constitucion. He fell ill on the 15th 
of September, and died on the 18th. Eieto's family, con- 
sisting of eight persons, were not attacked, although they 
communicated freely with the sick man. 

Two men who had come from Xeres de la Fron- 
tera, where the fever was epidemic, and who stopped at 
a house in the Posada Xueva, are stispected of having 
imported the malady.* 

The second case occurred at a distance of five hundred 
yards from the former, in the person of Maria Catalina, 
a girl sixteen years of age, who resided in the Calle Xueva. 
She became indisposed on September 15, and died on the 
21st. The girl had no commtmication with Eiega or his 
family. Ten persons living in the same house with Maria 
proved immune to the infection. 



'"^ La Roche, vol. 1, p. 534. 

^'Robert, Guide Sanitaire, vol. 1, p. 284; Berenger-Feraud, p. 
84; Bally, Francois and P?riset, p. 559. 



SPAIN LEBRIXA. 573 

A man named La Paz, residing in Calle la Pena, fur- 
nished the third case. He was taken ill September 16, 
and died on the 23rd. He resided 250 yards from Riega's 
place. No one in the La Paz household was affected, with 
the exception of a child, who contracted the disease two 
months afterwards, at a time when the malady was almost 
extinct. 

A youth named de Salas, aged eighteen, furnished the 
fourth case. He resided in the Bario Nuevo Secundo, 
about 250 yards distant from the nearest house in which 
the cases previously noted occurred. He was taken ill 
September 20, and died on the 28th. 

Two weeks after the death of de Sales, the fifth case 
was recorded, in the person of a boy, who lived in the same 
neighborhood, and who died thirty-six hours after the 
onset. 

The above first ^ye cases, taken from O'Halloran's^^^ 
work, are given to show that the original focus was 
within a comparatively restricted area, and undoubtedly 
owed its infection to the two voyagers froni^ Xeres de la 
Frontera.* 

From this focus, the disease slowly spread through the 
town. Contrary to the usual dilatory tactics of the Cas- 
tillian, the Lebrixa Board of Health acted quickly and 
energetically, and caused all the healthy inhabitants who 
could do so to emigrate to the country, by this means pre- 
venting a repitition of the disaster of 1800. From the 
most authentic sources, there were only 500 cases, of which 
150 died. 

LORCA. 

1811. 

Lorca, forty-two miles southwest of Murcia, was in- 
fected in 1811. The disease did not spread.^ ^^ 

^® O'Halloran: Remarks en the Yellow Fever, etc., p. 151. 

* The Spanish authorities claim that these men came from 
Puerto de Santa Maria, but authentic researches made by 
Dtr. O'Halloran elicited the information that they were 
from Xeres de la Frontera. (O'Halloran, p. 15&, foot note.) 

^^' Bally, Francois and Pariset, p. 560. 



I 



.574 HISTORY OF YELLOW FEVER. 

LOS HUMEEOS. 

{A suhiirh of Seville^ which see) 
LOYOLA. 

1823. 

Loyola, the birth-place of the founder of the Order of 
Jesuits, was threatened with an invasion of yellow fever 
in 1823. In August of that year, the shi-p - Doniasteria^ 
from Havana, arrived at Pasajes and was visited by many 
inhabitants of the Basque town. Among the visitors were 
two persons, husband and wife, who had stopped at Pas- 
ajes on their way to a pilgrimage to Loyola. After visit- 
ing the ship, they continued to their destination, where 
they were taken ill shortly after their arrival, and died 
of yellow fever a few days afterwards. Although much 
apprehesion was felt by the inhabitants of the quaint old 
Spanish town, the infection did not spread beyond these 
two cases. 

;A reference to Pasajes, in this volume, will show that 
the Doniastera infected that locality in 1823, result- 
ing in 101 cases and 10 deaths. 

MADKID. 

Description. 

Madrid, the capital of Spain, is in the center of the 
Peninsula, on the Manzanares. Situated on a high 
plateau, 2,400 feet above sea-level, wind-swept from the 
snowy Guadarrama, with unhealthy extremes of temper- 
ature, the city has no advantages except the fanciful geo- 
graphical merit of being the center of Spain. Railways 
connect it with the principal cities of the Kingdom. 
Population: 1887, 470,283; 1908 (estimated), 556,663. 



SPAIN MADRID. 575 



Yellow Fever Years. 
1867; 1870; 1878. 

. Summary op Importations. 
1867. 

Yellow fever has never obtained a foothold in Madrid. 
Even during the calamitous disorders of the beginning 
of the last century, when Andalusia was nearly depopu- 
lated and cases were imported to nearly every city of the 
Kingdom, although Madrid received its quota of fugitives, 
not a solitary case manifested itself in the capital. 

The first case of yellow fever in the history of Madrid 
was observed in 1867. In December of that year, a man 
who had been to the Canaries, arrived at Cadiz on the 
steamship Clara. Deaths from yellow fever had occurred 
on board the vessel. The man went from Cadiz to Madrid 
and was taken ill in his lodgings on December 3, and 
died on the 7th. The autopsy revealed typical lesions of 
yellow fever.^^^ 

1870. 

The captain of the merchant vessel Torciiato came from 
Barcelona to Madrid on September 29, 1870, and was 
taken ill with yellow fever immediately on his arrival. 
He recovered. Our authority^^^ does not state whether 
other cases occurred in Madrid or not, and as a search 
through the Spanish medical press of 1870 and subse- 
quent years fails to throw any light on the subject, it is 
to be presumed that there were none. Eager ( loc. cit.y p. 
24), says that "a few cases" were observed, but we have 
been unable to verify the statement. 

• ^«°De Pedro: Un Caso de Fiebre Amarilla an Madrid. Slglo 
Medico, Madrid, 1868, vol. 15, p. 20. 
"^De Pedro: Un Emigrants de Barcelona en Madrid; Fiebre 
Amarilla. Siglo Medico, Madrid, 1870, vol. 17, p. 676. 



576 HISTORY OF YELLOW FEVER. 

1878. 

In September and October, 1878, many Spanish soldiers 
returned from Cuba. They disembarked at Santander, a 
seaport on the Bay of Biscay, 207 miles north of Madrid, 
and the majority went by rail to the capital. Among the 
soldiers were a great number Ayliose term of seryice had 
expired and who, haying no families, took up bachelor 
quarters in Calle Tetuan, in a mean, filthy dweling, where 
they slept fifteen or twenty in the same room. Among 
these Ucenciadas were many who had yellow feyer in 
Cuba, and also some who had neyer contracted the 
disease. ' 

On September 15, a youth of fifteen, who liyed in Calle 
Tetuan, was taken ill with peculiar symptoms which 
baffled the attending physician. Four members of the 
youth's family were soon attacked with the same myste- 
rious disease, and when two other persons in the same 
house were taken ill, considerable alarm was created and 
an inyestigation by the health authorities reyealed the 
fact that these cases were genuine manifestations of yel- 
low feyer. Prompt measures were immediately taken, 
but the malady spread to the adjoining houses in Calle 
Tetuan, making slow, but steady progress, only subsiding 
with the adyent of cold weather. The last case was ob- 
seryed October 15. There were in all fifty cases, of which 
thirty-fiye proyed fatal.^^^ 

MAIKENA DEL ALCOK. 

1800. 

A few cases of yellow feyer were imported to Merina 
del Alcor in 1800, principally from Seyille, thirteen miiles 
distant. Only nine fatalities are recorded.^^^ 



'"Guichet: Memoires de Medecme Militarie, 1878.. Also: 

Berenager-Ferand, p. 158; Eager, p. 24. 
* La Roch«, val. 1, p. 534. 



577 



MALAGA. 

Description. 

The ancient and historic city of Malaga, said* to have 
been founded by the Carthagenians, is situated on a bay 
of the Mediterranean, sixty-five miles east of Gibraltar. 
It is of much commercial importance. Population (1908), 
135,000. 

The Epidemics of Malaga. 

We shall premise the history of yellow fever in Malaga 
by a summary of the several pestilential diseases which 
have ravaged the famous Spanish city since 1487, the year 
of the expulsion of the Moors from the Kingdom. Pre- 
vious to 1487, no records were kept. ■ 

In an old Spanish work published by Gecilio Garcia 
de la Lena,^^^ a learned priest of Malaga, the history of 
every epidemic which invaded his native town from 1493 
to 1750 is given. The ecclesiastic designates these pesti- 
lential visitations by the common name of plague, no mat- 
ter what the etiology of the disease could have been. 

1493. First epidemjic of which there is any record. 
Great mortality. No details given. 

1522. Plague caused excessive ravages. The details 
are too vague to recognize anything but the great 
mortality. 

1580. This epidemic is designated by the name el 
catarro by the good Padre. About eighty persons died 
daily. A torrential rain, on October 10, stopped its 
ravages. 

"^•Cecilio Garcia de la Lena: Conversaciones Historicas Mala- 
guenas, 1789-1793. 



578 HISTORY OF YELLOW FEVER. 

1582-1583. This epidemic was caused by the introduc- 
tion of old clothes brought by strangers coming from 
^^countries across the sea/' What countries, the learned 
historian does not say. The malady was attended by 
bubos. 

1597. The "Fifth Plague" to harass Malaga broke out 
in 1597, and lasted three years. As in 1582-3, it was in- 
troduced "by sea." Nearly the entire population of the 
town perished. 

1620. Plague again introduced into Malaga "by per- 
sons coming from the sea." The mortality was such, that 
'the government was compelled to send families from other 
towns to re-people the stricken city. 

1637. Padre de la Lena goes into more details con- 
cerning the "Seventh Plague," which was brought to 
Malaga by a vessel "on its way to Leghorn." (He does 
not state whence the ship originally sailed. While in the 
harbor, an inhabitant of Malaga went on board the vessel, 
where he remained all night. When he returned home 
next miorning, he was taken sick and died shortly after- 
wards. His whole family shared the same fate. The 
doctor who had treated these unfortunates, warned the 
people that they had died of plague, but his admonitions 
were disregarded, and the neighbors invaded the house 
and took possession of the clothes and furniture. By 
this means, the disease was communicated to neighboring 
streets and spread rapidly through the town, and even 
to neighboring villages. From the beginning of April to 
the end of May, the entire city was infected. Entire 
streets were improvised into hospitals, and the public 
parks were transformed into huge furnaces, where the 
clothing of the dead was burned night and day. The 
epidemic only stopped for want of material, about Sep- 
tember 1. The mortality is variously estimated by dif- 
ferent authors at twelve thousand, seventeen thousand and 
twenty-five thousand. 

1648-1649. Famine and the influx of strangers into 
Malaga are given as predisposing causes of the plague 



SPAIN MALAGA. 579 

of 1648-9. The mortality was not great in 1648, but it is 
said that 40,000 people died in 1649.* 

1674. A pestilential disease, called el catarro, caused 
much mortality in 1674. No details are given. 

1678-1679. The plague of 1678-9 was brought from 
Oran and Carthage (Africa) by strangers bringing in old 
clothes and chattel. Although the epidemic lasted two 
years, our author states that ' Ve are happy in the thought 
tha only 8,000 persons perished, notwithstanding the fact 
that the city was very populous." 

1719. The epidemic of 1719 had its origin in Africa. 
The malady broke out among the troops which had befen 
sent to defend Ceuta, Morocco, from the Moors. Many 
of the sick soldiers were tranferred to Malaga, and com- 
municated the contagion to the inhabitants. The epi- 
demic, whose principal characteristics were malignant 
fevers {tdbardillos) , lasted several months and caused 
much mortality. 

1738. This epidemic is also designated tahardilloSy and 
is said to have been engendered by the great famine of 
1734, the most cruel of the epoch. More than forty per- 
sons died daily. The total mortality is not stated. 

1741. Although designated by the name "plague'' by 
Padre de la Lena, the epidemic of 1741 was nothing else 
but yellow fever, the details of which will be found in 
our relation of the eruptions of that disease in Malaga. 

1750-1751. This epidemic, also characterized by the 
name tabardillos, caused 6,000 deaths. Its origin is not 
given. 

According to de la Lena, no pestilential diseases were 
observed in Malaga from 1751 to 1793, the year of the 
publication of his monograph. 

Diego Blanco Salgado, a distinguished Spanish physi- 
cian, sent by the King to study this epidemic, also wrote 
on the subject. 



* Rodrigo Enriques and Jaun Serrano de Vargas Ykrena liave 
also written histories of this plague. 



580 HISTORY OF YELLOW FEVER. 

Yellow Fever Years. 
1741; 1791; 1802; 1803; 1804; 1813; 1820; 1821; 1890. 
Summary of Epidemics. 

1741. 

A French squadron coming from Martinique touched 
at Malaga in 1741. Yellow fever was prevailing on board 
the vessels, but the commander concealed this fact from 
the port authorities, and the officers and crews had un- 
interrupted communication with the town. The disease 
soon broke out in Santo-Domingo street, in a locality 
which had been much frequented by the French marines. 
Thence it spread rapidly through the town and even in- 
vaded its suburbs. The epidemic lasted three months 
and, according to Barea,^^^ more than 10,000 persons 
died. Kubio, however, claims that only 3,000 died,* but 
the majority of chroniclers assert that the figures given 
by Barea are approximately correct. 

1791. 

Robert {Guide Sanitaire^ vol. 1, p. 271), claims that 
Malaga suffered from yellow fever in 1791, and that 
10,000 persons perished.* We have looked through the writ- 
ing of Bally, Ozanam, Eager, Berenger-Feraud and old 
Spanish documents and works on epidemiology, but can 
not substantiate this statement. Even Gendrin, in his 
elaborate monograph on the epidemics of Spain, published 

"* Barea: Conversaciones Malaguenas, p. 51. 
Rexano: Chrisis Epid6mica, 1742, Section 20. 
Cecilio Garcia de la Lena, loc. cit. 

Gendrin: Journal General de Medecine, 1824, vol. <S8, p. 293. 
Chervin: Examen Critique, etc., 1828, p. 26. 
♦This historian's exact language is as follows: 
"Pericieron, segun el mas rigcroso escrutino, tres mil personas, 
pocos mas o memos." — Rubio, Analysis Medica, etc., p. 20. 
* "* * * Malaga, qui, en 1791, vit introduire dans ses murs une 
affreuse contagion, et compta dix mille victimes." 



SPAIN MALAGA. 581 

originally in the Journal General de Medicine for 1824 
(vols. 88 and 89, pp. 289 and 10, respectively), is silent 
on the subject. A few sporadic cases, which escaped the 
attention of other observers, probably occurred ; but the 
excessive mortality mentioned by Eobert as having taken 
place in 1791, is undoubtedly a chronological hiatus. 

1802. 
In 1802, yellow fever was imported to Cadiz, and thence 
spread to other cities on the south coast of Spain. A few 
sporadic cases were observed in Malaga.^^^ 

1803. 

The mild visitation of 1802 was but a premonition of 
the terrible epidemic which was destined to afflict Malaga 
the following year. 

Likely, nearly all the disastrous visitations of yellow 
fever which desolated the southern cities of Spain during 
the first quarter of the last century, the origin of the 
Malaga disorder of 1803 is shrouded in obscurity. The 
details which follow are culled from t^he most reliable 
authorities on the subject.^^^ 

^^^ Eager, p.. 17; Berenger-Feraud, p. 72. 
^^^ Summarized from: 

Guendrin: Journal General de Medecine, Pari^ 1824, vol. 88, 

pp. 289 €t seq. 
Alfonso da Maria: Memoria So'bre la Epidemia de Andalusia 

de 1880 al 1819. Cadiz, 1820, p. 122. 
Fellowes: Reports of the Pestilential (Disorders of Andalusia, 

p. 157. 
Mendoza: Historia de las Bpidemias Padecidas en Malaga en 

los anes de 1803 y 1804. Malaga, 1813. 
Arejula: Breve Descripcion de la Piehire Amarilla Padecida 

en Cadiz y Pueblos Comercanos en 1800, en Medina Sidonia 

en 1801, en Malaga en 1803, etc. Madrid, 1806, 
Eager: Bulletin No. 5, Yellow Fever Institute, p. 17. 
Berenger-Feraud, p. 73. 
La Roche, vol. 1, p. 536. 

Bancroft: Essay on Yellow Fever, pp. 468; 471. 
Bancroft: Sequal to an Essay on Yellow Fever, p. 309. 
Keating: History of Yellow Fever, ;p. 81. 
Bally: Typhus d' Amerique, p. 81. 



582 HISTORY OF YELLOW FKYKR. 

The Suspected Carriers of Infection. 

The historians of this epidemic accuse the following 
vessels of having infected Malaga in 1803 : 

1. The Joven Nicolas^ a Dutch store-ship, sailed from 
Smyrna on the i4th of March, 1803, and arrived at Malaga 
on the 22nd of May, after a passage of seventy days, and 
having during that period touched at different ports. 

2. The French brig Desaioo, chartered by the French 
Government to convey troo^i's tlo St. Domingo, sailed 
from Marseilles on the 26th of April, 1803, with 171 men, 
chiefly deserters, prisoners and convicts. Almost the 
whole of them had been forced on board, and were taken 
from forts St. John and St. Nicolas (at Marseilles), in 
which the jail fever at that time prevailed. Fourteen of 
these unfortunates were convalescents and had lately been 
discharged from the hospital. This vessel entered Malaga 
on the 17th of May, having lost during the voyage thirteen 
men; thirty-six on board whilst under strict quarantine 
in the bay, and three in the fort of Gibralfaro, which over- 
looks the town of Malaga. 

3. The French brig VUnion^ also chartered by the 
French Government, sailed from Marsaille on the 5th of 
May of the same year, with 150 men of a similar descrip- 
tion, besides twelve sailors ; they had been embarked from 
Fort St. Nicholas, at Marseilles, where the jail fever pre- 
vailed; and this vessel entered the harbor of Malaga on 
the 3rd of June, 1803. During the passage, seven men 
died, and eight on board in the bay. Total deaths, sixty- 
seven. This was the French account, but they lost many 
more, who, as reported, had drowned themselves or de- 
serted. On the 18th of August, 1803, the remainder of 
the people were permitted to disembark, and they were 
conveyed at night to the Moorish Castle of Gibralfaro. 

On the 7th of September, 1803, the two brigs were ad- 
mitted to pratique. 

4. The Spanish ship Providencia, belonging to Manes- 
cau and Co., Malaga, from Monte Video, and laden with 
cocoa, hides and tallow; she entered the bay of Malaga 



SPAIN MALAGA. 58S 

on the 9th of June, 1803, and was admitted to pratique 
a few days after her arrival. 

The Celebrated Case of Felix Munoz. 

It was generally asserted and believed by Arejula, that 
the first man who died of the epidemic in Malaga was 
Felix Munoz, a noted smuggler. On or about the 14th of 
July, he was known to have gone on board the J oven 
Nicolas^ whence he brought away samples of cotton and 
tobacco, and he himself confessed to the physician who 
attended him, that from the moment he left the ship, he 
felt ill. 

In fact this man on his return home, took to his bed 
and died on the fifth or sixth day of his illness. 

This circumstance produced at the time great constern- 
ation in Malaga ; immediately after his death,^ his wife 
and all his family fled into the country and did not re- 
turn until late the following year^_Hence, Arejula con- 
cludes that as no one entered the house, the disorder of 
wrhich Munoz died, did not spread, and the alarm subsid- 
ing, no further notfce was taken. 

From this period there was an interval of thirty-five or 
thirty-six days until the sickness broke out in the Ver- 
duras family, which is regarded as the source of the 
epidemic. 

As the J oven Nicolas came from Smyrna, where yellow 
fever has never prevailed — as least, within recorded times 
- — We fail to see how Munoz could have contracted the 
disease by simply visiting the ship in the interest of his 
nefarious business. If he died of yellow fever — in our 
humble opinion a remote possibility — he contracted it 
elsewhere. 

The Real Origin of the Epidemic. 

Out of the mass of discussions, denunciations, recrimi- 
nations and dissensions, which even the courts failed to 
untangle, the following facts are called: 



584 HISTORY OF YELLOW FEVER. 

The disorder which broke out in Malaga in 1803, com- 
menced in the house of Christopher Verduras, living in 
the district of Perchel, on the west side of the Guad- 
almedina. 

Verduras was a caulker by trade, but a noted smuggler, 
and a person who was likely from his character to do any- 
thing for gain. It was generally reported in Malaga that 
this man about the latter end of August, had brought a 
person from one of the vessels in the bay — some say it 
was an American vessel, others a Dutch ship^ — and se- 
cretly conveyed him to his house. This person was then 
suffering from a disease of which he soon after died. It 
was afterwards discovered that the body was buried pri- 
vately in the neighboring church of St. Peter, in the mid- 
dle of the night. 

Arejula states that the interment took place with the 
connivance of the curate of St. Peters. The priest was 
himself taken ill and died of the disease, together with 
the physician who attended him. These two were sus- 
pected of having been interested in the smuggling trans- 
actions that were going on in the Venduras household. 
If such were the case, retribution came unmercifully, for 
every person connected with the curate's house, was taken 
ill and died; even the sacristan and his wife, as well as 
the monaguillo, or altar-boy. 

"The facts were well known at the time," says Arejula, 
"and it was affirmed by all the inhabitants of the district 
De Perchel that those who had entered the Church of St. 
Peters to hear mass on St. Michael's day, were taken ill, 
and a great part of the congregation died." 

Fellowes says that, on this account, the people con- 
ceived so great a horror of this edifice, that it became 
necessary to shut it up, and it continued closed until 
December 18, 1805, w^hen Dr. Arejula, accompanied by 
several physicians of Malaga, fumigated it with oxygen- 
ated muriatic acid and other germicides. 

On the 26th of August, Michael Verduras, the son of 
Christopher, was taken ill in the same house, and from the 
report of the physicans who attended him, there is no 



SPAIN MALAGA. 585 

doubt of his having died of yellow fever. In two or three 
days after Michael had fallen sick, two other men, friends 
of his, and caulkers by trade, who worked with him, were 
also attacked with the fever. One of them died ; the other, 
Lucas Perez, recovered. 

Shortly after the death of Michael Verduras, which 
took place on September 3, his mother and two sisters 
sickened w^ith the same symptoms. Christopher Ver- 
duras died on the 15th of September. His daughter and 
another son, , Antonio were also attacked and died on 
the 19th. 

Whilst the fever was running through the Verduras 
family, Dr. Del Pino, who had treated all the members of 
the family, was called to visit a young man, a sailor, 19 or 
20 years of age, who lived in a house immediately op- 
posite to that of Verduras, and was the friend and com- 
panion of Michael. His symptoms were similar. About 
the same time Pascual, a baker, who lived in a house ad- 
joining to Verduras, was attacked with the disorder, and 
the similarity of symptoms was so remarkable, that Dr. 
Del Pino called a consultation, in which it was deter- 
mined that a report should immediately be made to the 
Governor of Malaga, of a very alarming disease having 
made its appearance, and the two physicians accordingly 
declared that they had seen several sick persons laboring 
under some alarming symptoms, such as were unusual 
in the place. The Governor received this report, and 
transmitted it to the Board of Health, but no notice was 
taken of the matter. 

The disorder, however, continued to spread gradually, 
not only in the narrow lanes and streets of the district 
de Perchel, whe^e Verduras had lived, but it afterwards 
extended to other suburbs, and to the adjoining districts 
of the Trinidad, Capuchins and Alto, which are at some 
distance from the Perchel. The spread of the infection 
to these localities was said to have been caused by the 
fact that many persons living there, principally laborers 
and workmen, joined early in the morning to hear mass 
in the church of the Corventico with those of Perchel. 
because the services were held earlier in that district. 



586 HISTORY or yellow fever. 

"It must be observed,'' says Fellowes, "that in Catholic 
countries, especially in Spain, the lower orders chiefly 
are very attentive to their religious duties, by going early 
to church to hear mass, previous to their entering upon 
the duties of the day." 

From this source, and in this manner, the disorder was 
undoubtedly propagated from the suburb of Perchel to 
other parts of the town. 

Fellowes, who made personal investigations concerning 
the rise and progress of this epidemic, visited Malaga in 
March, 1806. From the result of his inquiries among 
all the survivors of the different families, it appeared that 
the disorder spread on the following order: 

1. Verduras. 

2. Pedro de Torre. 

3. Gabriel Vasquez. 

4. Blaize Martin. 

5. Francisco Ferrari. 

Martin's house, directly opposite Verduras, was the 
third attacked, and had eleven cases, of which five died. 

Ferrari lost his wife, two sons, a daughter and a 
nephew — all living in the same house. 

From these foci^ the pestilence gradually advanced, un- 
til the entire city was invaded. Consternation was now 
general; terror multiplied the dangers. Of the 48,015 
inhabitants that Malaga numbered at the beginning of the 
epidemic, thousands fled, sowing the seeds of pestilence 
throughout southern Spain.* 

The following statistics, compiled by Guedrin from doc- 
uments furnished by the Spanish Government at the time 
of his investigations, is taken from the Journal General 
de Medicine for 1824, (vol. 88, p. 308), and may be con- 
sidered authentic : 

* Algerziiras, Alicante, Antequera, Barcelona, Cadiz, Espera, 

Gibraltar, La Rambla, Montilla and Palma owe their in- 
fection in 1803 to Malaga. 

* In his "Sequel to an Essay on Yellow Fever," p. 319, Bancroft 

refers to Fellowes' criticism of his error, but makes no 
explanation. 



SPAIN. MALAGA. 



587 



Tableau of the Malaga Epidemic of 1803. 



Population of Malaga. 


No. who Fled 


'o. Remain'g 


GASES 


DEATHS 




Males 


Females 


Males 


Females 


Males 


Females 


Males 


Females 


Males 


Females 


Citizens 


20.142 


24,093 


1,624 


1,972 


18.518 


22.121 


5,257 


5.600 


2,722 


2,289 


Hospitals 


75 


23 








75 


23 


4.864 


563 


1,379 


312 


Suburbs 


744 


472 


132 


2 


612 


470 


140 


93 


60 


28 


On Ships 
Military .- 


Un 
6,068 


cnown 
128 


Un 

C 


known 



1,794 


Un] 
6,068 
25,273 


inown 

128 
22,742 


Unknown 
Troops were 
segregated 

. 261 6.256 


94 
NoC 
De 

4.255 



.ases or 
aths 


Totals by sex 


27,029 


24.716 


1.756 


2,629 


Grand Totals 


51 


,745 


- 


,730 


43,015 


16.517 


6,884 



From this table, it will be seen that out of a population 
of 51,745 souls, 3,730 fled and 6,196 were segregated, leav- 
ing 41,819 exposed to the fury of the pestilence. Of this 
remainder, 16,517 (or 2 out of 55) contracted the disease, 
and 6,884 (or 41 for every 100) died. 

The epidemic was officially declared extinct on Decem- 
ber 20, having lasted two months and twenty days. 



1804. 



The epidemic of 1804 was still more disastrous than 
that of the previous year. Its origin is obscure, but as 
no fresh importation could be proven, the recurrence of 
the malady was no doubt due to the renewed activity of 
the Stegomyiae Calopae, which had remained quiescent 
during the winter and spring. 

Stegomijiae Calojjae have a habit of hiding in old clothes 
hanging in closets, or hibernating in draperies, curtains, 
etc., and are capable of retaining the virus in their system 
for months. Manson {Tropical Diseases, 1907, p. 213), 
says that the usual period is fifty-seven days, but in- 
stances are of record where mosquitoes which had fed on 
blood of yellow fever patients, survived for five months 
or more. In this connection, the recrudesence of the epi- 



588 HISTORY OF YELLOW FEVER. 

demic of Malaga can easily be explained. The first epi- 
demic ended December 20, 1803. From that date until 
June 29, when the initial case of the second and greater 
epidemic erupted, is a trifle more than six months. 
Sporadic cases of mild yellow fever probably occurred 
previous to June 29, but their mildness prevented the true 
nature of the disease from being recognized, and it was 
only when the virulent manifestations in Pozos Dulces 
street threw the populace into consternation, that the real 
situation was thoroughly understood. 

The historians of this great epidemic are many. We 
have summarized the following account from the most 
reliable.^^'^ 

The first case of unequivocal yellow fever in Malaga in 
1804 erupted on June 29, at No. 12 Pozos Dulcas street, 
where two natives, Rinz and Ximenes died. As soon as 
the news became public, a wild panic ensued and the in- 
habitants, recalling the horrors of the preceding year, fied 
in swarms. On July 1, all but those who were too poor 
to get away had sought fancied security in fiight, and in 
their mad rush spread the pestilence broadcast throughout 
Andalusia. 

Bancroft, in his Essay on Yellow Fever (p. 468), falls 
into a serious error when speaking of the epidemic of 
1804. He claims that it first appeared in the Barrio de 
Perchel, as in 1803. Fellowes (page 177) and Gendrin 
{Journal de Medicine, 1^2i, vol. 84, p. 314), conclusively 
prove that the disease broke out in Pozos Dulces street in 
1804, in an opposite part of the town. This is confirmed 
by Mendoza^s work on the subject and other historians, 
who declare that the Barrio de Perchel, the focus of the 
disaster of 1803, was not affected in 1804 until the begin- 

^" Gendrin, loc. cit., vol. 88, p. 312. 
Arejula, loc. cit. 
La Roche, vol. 1, p. 536. 
Fellowes, p. 478. 
Bally, p. 85.. 

Bancroft, (Sequel, p. 320. 

'Medical Repository (N. Y.), 1805, vol. 8, p. 430. 
Berenger-Feraud, p. 76. 



SPAIN MALAGA. 589 

ning of September, more than two months after the first 
deaths at No. 12 Pozos Dulces street.* 

But we have no concern mth the polemic quarrels of 
the pros and cons of contagions who spent the best years 
of their lives in trying to prove each other falsifiers and 
charlatans. Let us return to our mutton. Between the 
29th of June and the 23rd of July, fifteen fatal cases oc- 
curred in Pozos Dulces street, in eight different houses, 
but little distant from each other. During that interval, 
only one fatal case had been observed in the city proper, 
and this was in Los Marmoles street, directly across the 
river from Pozos Dulce street. By the. end of July, the 
total mortality had reached 129. In the beginning of 
August the fever appeared almost simultaneously in many 
parts of the city, followed by a heavy mortality, the 
deaths being as many as fifty a day. The epidemic then 
seemed to subside, and by Alugust 11, the deaths had con- 
siderably diminished. On the 14th, the conditions had 
so improved that the phj^sicians of the place subscribed 
the following opinion before a magistrate, which was 
promulgated throughout the city: 

"We, the undersigned physicians, certify that no epi- 
demical disease prevails at Malaga at present. It is a 
sort of ague or malignant fever, similar to that which 
rages in many other parts of Spain; and it has of late 
so much subsided, that out of twenty people taken ill, 
only five died ; whilst, on its first appearance, fifteen died 
out of twenty. We hope that by the use of gentle medi- 
cines and by taking the necessary precautions of fumigat- 
ing the houses where the disease has existed. It will soon 
disappear." 

The subsidence of the disease was but the lull before 
the storm. The proclamation had hardly been posted, 
than new foci erupted everywhere, and the death-rate be- 
came appalling, 1,640 fatalities being recorded for the 
month of August alone. / 

The epidemic reached its greatest intensity September 
7, when 300 deaths occurred. The mortality continued 
to be excessive during September. In Octob'er, the disease 
slowly subsided, finally becoming extinct on the 28th of 



590 HISTORY OF YELLOW FEVER. 

November, having raged five months and one day. 

Even as late as December, the afflicted town was like a 
vast necropolis. The following account is extracted from 
a letter dated December 3, ISOJ:, written by an inhabitant 
of Malaga, and published in the ^ew York Medical Re- 
positori/^ vol. 8, 1805, p. 431 : 

^'It is impossible to form a just idea of the aspect ex- 
hibited by our unfortunate city. It resembles a desert. 
The mortality here has in some measure ceased, it is true, 
for want of victims. Seven thousand persons only have 
escaped its attack ; twenty-six thousand have fallen a sac- 
rifice to it. 

"The effects of this great disaster are remarked in every. 
thing that surrounds us. The grapes have rotted on the 
vines for want of hands to gather them. On all sides we 
hear the cry of Bread I Bread ! The plague is everywhere 
succeeded by famine. 

"In most parts where the epidemic has prevailed, the 
following observations have been made : It was less fatal 
to females than to males, and it appears that it had no 
influence on old women, for they continually assisted the 
sick without being attacked by it. Persons of a delicate 
constitution were also less subject to its fatal effects 
than those of robust constitution. In re.sfard to the 
nejrroes it scarcely prodticed any effect on them.-' 

With the exception of the statement that 26,000 per- 
sons died, an exasfgeration which is pardonable, owing to 
the desolation which surrotinded the writer, the above 
letter may be taken as a faithful pen picture of the 
situation. 

The Awesome MortalUy. 

The total population of Malao-a in 1804 was 44,020, of 
which 23,190 were males and 20.830 of the <zentler sex. 
At the beginning of the epidemic, 4,548 fled, leaving 
39.472 exposed to the influence of the pestilence. 

There were altogether 18,787 cases, of which 8.989 were 
men, and 9,798 women. Of this number, 7,476 men and 
4,010 women perished, a total mortality of 11,486. 



SPAIN MALAGA. 



591 



Twenty doctors and nine pharmacists died. At one 
time, there was only one physician in the entire city able 
to minister to the sick, the others being either dead or 
sick with the fever. The practitioner who escaped an 
attack had had yellow fever in 1803. 

If the reader has attentively followed the dismal history 
of the epidemics which devastated Malaga, he will no 
doubt be struck by the difference in population between 
the years of 1803 and 1804. This is readily accounted for 
by the fact, that on December 20, 1803, the population 
had been diminished by 6,884, and that deaths from va- 
rious causes must have caused a still greater decrease up 
to July 1, 1804. It is obvious that six months and ten 
days is too short a period to permit any material increase 
under the fundamental laws of Nature. 

Comparative Mortality hetiueen 1803 and 1804. 

The difference in the mortality according to age and 
sex during the sinister epidemics of 1803 and 1804, is thus 
given by Gendrin (loc. cit., vol. 88, p. 321) : 




It will be seen from the above resume that the mortality 
was abnormally great among young persons, 2,351 under 
30 years of age being carried away in 1803, and 4,202 in 
1804. 



592 HISTORY OF A'ELLOW FEVER- 

1813. 

In 1813, a ship from Gibraltar, where yellow fever was 
prevailing, brought malady to the port of Malaga, in- 
fecting all those who had any communication with it. 
Being on the alert, the disease was at once recognized by 
the Superior Board of Health, and energetic measures 
instituted. All the sick were transported to the lazaretto, 
and the houses they occupied were closed and guarded. 
A mortality of twenty-seven is recorded.^^^ 

1820. 

In 1820 a family affected with yellow fever, left Xeres 
de la Frontera and came to Malaga. The nature of their 
illness was at once discovered by the authorities, and 
they were removed to the lazaretto, together with all 
those who had communicated with them. There was no 
extension of the disease.^^^ 

1821. 

The appalling epidemics of 1803 and 1804 seem to have 
exhausted the non-immune material in Malaga, for though 
we read of yellow fever having been observed at Cadiz in 
1807 and 1808, and nearly every year from 1811 to 1821, 
as well as in seventeen cities and towns of Andalusia in 
1811, Melaga kept the yellow pestilence away from its 
doors for sixteen years. In 1821, however, much appre- 
hension was felt for the safety of the city, the disease hav- 
ing been introduced under the following conditions'.^'^ 

Between June 7 and 22, 1821, twelve ships forming 
part of a convoy which had sailed from Havana April 28, 
entered the port of Malaga. There was much sickness on 
board these vessels during the voyage across the Atlantic, 
especially on board the >Sfa^ Antonio and the JAheral^ the 

^^ Gendrin, loc. cit, vol. 88, p. 328. 
^^'Gendrin, loc. cit., vol. 88, p. 328. 

"* Gendrin, loc. cit., vol. 89, p. 10; Bally, Fran<M3is and Pariset, 
p. 112. 



SPAIN MALAGA. 593 

latter having lost her captain at sea. The frigate Lih- 
ertady which formed part of the convoy, was accused of 
having sent some sick sailors and a few cases of mer- 
chandise on shore. All these vessels carried suspicions 
clearance papers, but they were, nevertheless, admitted 
to pratique after only a short quarantine. Some were 
admitted even without going through this formality. 

The Danish schooner Initium, from Barcelona, which 
arrived at Malaga on August 1, is the only vessel directly 
accused of having infected the port. During the six days 
the vessel took to make the voyage from Barcelona, out 
of a crew of six and one passenger, four cases of yellow 
fever, of which one proved fatal, had occurred on board. 
On arrival, the three cases were transported to the laz- 
aretto of Los Angeles, on the outskirts of the city, where 
two died. In spite of its flagrant unsanitary condition, 
the Initium was given free pratique on August 11. Two 
Swedish sailors, who went on board that day, were 
stricken shortly afterward and sent to the lazaretto, where 
they died. This last incident was not made known to the 
board of health. 

Rumors began to circulate that a strange malady was 
causing much mortality among the vessels in port. On 
August 21 and 22, a delegation from the Superior Board 
of Health began an investigation and discovered that five 
vessels, moored on both sides of the Initium, had had sus- 
picious cases of fever. 'While the committee was urging 
immediate measures and the board of health was demur- 
ring, the Danish consul appeared on the scene and re- 
ported that two undoubted cases of yellow fever were at 
that moment on board another ship of his nation, and 
requesting that "something be done'' in the premises. 
This spurred the nonchalant members of the board of 
health into action, and they went to extremes. All ves- 
sels, whether infected or not, were ordered to quarantine, 
the port was closed and communication between the Mal- 
aganese and "any vessel in port" positively prohibited. 
The authorities even went so far as to send to the laz- 
aretto an entire family, at whose house one of the sailors 
of the Initium had taken lodgings. Although not a single 



594 HISTORY OF ^-ELLOW FEVER. 

case had developed in this house, it was bermetically 
closed. 

This sudden frenzy of precautionary measures threw 
the population of Malaga into consternation. They im- 
agined the pestilence already in their midst, and an in- 
describable terror took possession of them. Thousands 
fled, abandoning relatives and business, and seeking 
refuge wherever they cotild. The exodus is said to have 
been more considerable than during the the epidemics of 
1803 and 1S04. After a few days, the public health con- 
tinuing good, calm was restored and the majority of those 
who had fled returned. 

In the beginning of September, it being the season when 
the produce of the surrounding country finds its way into 
the markets of the town, nothing untoward having taken 
place in the stattis of the public health, the port was 
re-opened to facilitate the handling of the increasing com- 
merce, and the segregated vessels again permitted to an- 
chor at the wharves. Quarantine regulations were re- 
laxed and uninterrupted communication had with the 
nondescript craft in the harbor. 

It was this lack of precaution which paved the way for 
the entrance of the pestilence into the city. 

How the fever finally invaded the town, is diflflcult to 
surmise from the publications of the period. It may be 
that the infection was diffused by persons commtmicat- 
ing with the Inifium. for the first cases were observed in 
the districts .of Alcazaba and Alcazabilla, inhabited prin- 
cipally by sailors and the poorer classes. The brig 
Sou vera in C&ngres, which arrived from Havana in Au- 
gust, with an unclean bill of health, and which had suf- 
fered from yellow fever during the voyage, is also in- 
criminated. It is said that the captain of this vessel and 
his crew came ashore as soon as the vessel was released 
from quarantine, and that the captain's family, residing 
in Alcazabilla. were first to contract the malady. 

By whatever means the disease was introduced, the 
first case presenting unmistakable symptoms of yellow 
fever manifested itself on September 6, in the son of Jose 
Rodriguez, a caulker, residing in the Alcazaba district, 



SPAIN MALAGA. 595 

whose parent had been employed on one of the vessels 
in port. The boy, aged 11, died on the 9th, but the father, 
taken ill almost simultaneously, recovered. The histo- 
rians of this epidemic accuse the elder Rodriguez of hav- 
ing brought the infection ashore, but as he was taken ill 
after his son, such a contention certainly seems absurd 
in this age of known mosquito transmission of the dis- 
ease. Personal contact and fomites were then held re- 
sponsible for the spread of yellow fever; but now, things 
are different. How the little fellow contracted the mal- 
ady, is a problem which cannot be satisfactorily solved 
at this late day, unless we take it for granted that, like 
all children of his age, he played about the streets in his 
neighborhood, already infected by persons from the ships 
in the harbor, and was bitten by Calopae, with the sad 
result above narrated. 

On September 12, three days after the death of young 
Rodriguez, a doctor reported that he had seen in Cober- 
tizo del CortenStreet a suspicious case of illness, followed 
by death on the fourth day. This patient had come from 
the Alcazaba district. The health authorities started an 
immediate investigation and declared that the man had 
died of a "suspicious contagious disease," and quarantined 
the house where he had passed away, i They went fur- 
ther and quarantined the residence of the governor of 
Alcazaba, whence the suspicious case originally came, 
and caused the oflficiars family to be forthwith transported 
to the lazaretto. The governor, who was ill, died on the 
26th. The authorities ordered that his house be hermet- 
ically closed and guarded, although it was plain to every- 
body that the poor man had not died of yellow fever, but 
of an ailment totally foreign to that disease. 

The public, already on the qui vive, were thrown into 
indescribable consternation by these rigorous measures. 
The terror became so great, that the inhabitants fled in 
multitudes, some even running through the streets and 
seeking refuge in the country, as if an invading army were 
pursuing them. 

On September 27, in the middle of the night, the physi- 
cians of Malaga were called together by order of the 



596 HISTORY OF YELLOW FEVER. 

Superior Board of Health, to arrive at some decision, as 
to the real character of the malady which was creating 
so much alarm. After considerable wrangling, a mani- 
festo was issued to the public, of which the following 
is the gist: 

"The undersigned physicians and surgeons declare that 
the general state of the public health is good ; but, in par- 
ticular instances, cases of a malignant malady present- 
ing the symptoms of yellow fever, have been observed. 
There actually exists three such cases, against which 
common prudence and a regard for the public health de- 
mand that measures of non-communication be adopted."* 

This was signed by thirty of the most prominent physi- 
cians of Malaga. 

On September 27, Dr. Mendoza (whose elaborate work 
on this and other epidemics of Malaga, are regarded as 
authorities), suggested that the district of Alcazaba, 
where the disease was concentrated, be isolated, arguing' 
that this would be an easy matter, as the infected quarter 
was connected with the city proper by two gates only. 
Dissensions among the members of the Superior Board of 
Health as to the propriety of such a measure prevented 
same from being adopted, and many inhabitants of Al- 
cazaba, fearing to be cooped up at any moment within 
the ancient Moorish citadel, fled to various parts of the 
city and thus spread the infection. 

Whether the Calopae were unusually inactive in Malaga 
in 1821, or causes which cannot be explained intervened, 
the disease did not spread rapidly nor does it appear to 
have been very deadly. Cases continued to crop out here 
and there during October and November, and by the end 
of the latter month, cold weather put an end to the activ- 
ities of the few straggling Calopae ^ and the epidemic was 
at an end. On December 2, Malaga was officially de- 
clared free from fever, and all quarantines raised. 



SPAIN MALAGA. 597 

The number of cases is not given, but the mortality was 
as follows : 

Sex. 

Month. Males. Females. Total. 

August 5 5 

September 17 3 20 

October .56 33 89 

November 67 39 106 

December 15 7 22 

Totals 160 82 242 

In the above table are comprised deaths in the city 
proper, in the shipping and at the lazaretto. 

1890. 

The Case of the Herman Cortes, 

Malaga narrowly escaped an invasion of yellow fever 
in 1890. The circumstances were as follows :^^^ 

The steamship Herman Cortes sailed from Havana 
April 28, 1890, and anchored at Malaga May 20. In ac- 
cordance with an old custom, the boys of the musical 
band from the Asylum San Bartolome, boarded the ship, 
entertained the passengers and spent several hours "feast- 
ing and making merry." On May 23, the ship departed 
for Barcelona. 

On May 25, one of the boys was taken sick with yellow 
fever and died four days later. On June 1, a second be- 
came ill and died on the 3rd. A third was attacked on 
the 11th and died twenty hours later. On the 15th and 
16th, two more cases appeared; both recovered. 

According to the authorities cited, these are all the 
cases that occurred at Malaga. The Herman Cortes came 
fromi New Orleans via Havana, laden with cotton, etc. 
Most of the cargo was unloaded at Malaga and stored in 

"^ Caro: Boletin de Medecine Naval, Madrid, 1890, vol. 13, p, 190. 
Ibid: Independencia Medico, Barcelona, 1889-90., vol. 21, p. 461. 
TJ. S. Public Health Reports, 1891, vol.. 5, pp. 286; 299. 



598 HISTORY OF ^-ELLOW FETER. 

factories and other establishments in the town, but no ill 
effects resulted. There was no yellow fever in Kew Or- 
leans in 1890. There had been yellow ferer in Havana 
up to three days prior to the arrival of the ship, but no 
cases occurred on board of the vessel either before ar- 
riving at Malaga or after leaving that port. 

Infected mosquitoes were undoubtedly taken on board 
with the cargo at Havana, and the weather being still too 
cool for them to venture in the open, they remained in 
the hold until Malaga was reached, when the opening of 
the hatches gave them an opportunity to sally forth and 
feed on the unfortunate orphans who had come on board 
to welcome their friends. It is a noteworthy fact that all 
the boys affected had been among the number who visited 
the ship. It is also worthy of note that all the boys were 
not affected, and that the passengers and crew of the 
Hennan Cortes escaped contamination. This is one of 
the extraordinary freaks of Nature which no human in- 
genuity can solve, and which conjecture only renders more 
mysterious and inexplicable. 

Nummary. 

First case, May 25 ; first death. May 29 ; last case, June 
16 ; last death, June 12. Total cases, 5, of which 3 proved 
fatal. 

MAXGEAT. 

1821. 

MalgTat, thirty-seven miles northeast of Barcelona, was 
infected by persons fleeing from the latter city in 1821.^'''^ 
There was no diffusion of the disease. 



"= Cornilliac: Recherches Chronologiques, siw I'Origin et la 
Propagation de la Fievre Jaune, etc., Fort-de-France, 1886, 
p. 408. 



SPAIN. 599 

MAZAREON. 

1804. 

Mazarron, twenty miles west of Cartagena, was infected 
by fugitives from that city in 1804. Tlie disease was con- 
fined to the imported cases. 

MEDINA-SIDONIA. 

Yellow Fever Years. 

1800; 1801; 1802; 1811; 1813. 

Summary of Epidemics. 

1800. 

Previous to 1800, yellow fever had never been observed 
in Medina- Sidonia. Fugitives from Cadiz infected the 
town that year, but the disease was not extensive, being 
confined solely to the imported cases. This was fortunate 
for the inhabitants of Medina-Sidonia, for out of 51 cases 
reported by the health authorities, 46 ended fatally.^"^^ 

1801. 

As no importation can be traced regarding the epidemic 
of 1801, it is natural to lay the blame to a revival of per- 
nicious activity on the part of the ^tegomyiae Calopae, 
infected the year previous. 

The historians of this epidemic claim that the infection 
was due to the opening of a house where fugitives from 
Cadiz had died in 1800, and which had remained closed 
until the middle of 1801. Viewed in the light of 1909, 
this statement serves to strengthen the mosquito theory. 

173 Periodico de la Sociedad Medico-Qurirgica de Cadiz, voL 3 
(Appendix), p. 49. 
(La Roche, p. 534, quoting Alfonso da Maria, p. 123, says that 
the deaths were 136.) 



600 HISTORY OF YELLOW FEVER. 

The first case erupted on August 3, followed by death 
on the 6th. The father of this case, taken ill on the 5th, 
died on the 9th. Another person in the same house was 
attacked on the 29th, and died September 2. The malady 
then spread rapidly and was especially severe in San 
Francisco, Loba, Santa Catalina, Cigarra and Sucia 
Streets. The epidemic came to an end on November 6, 
resulting in 821 fatalities.^"^^ 

1802. 

A few cases of yellow fever were observed at Medina- 
Sidonia in 1802. No reliable details are obtainable.^'''^ 

1811. 

Cadiz infected Medina- Sidonia in 1811. Only a few 
cases were observed.^'^^ I 

1813. 

Sporadic cases appeared in 1813. The invasion does 
not seem to have been extensive. ^^"^ j 

MEQUINEN^A. ' 

1821. 

Mequinenza, a small town on the Ebro, was only invaded 
once by yellow fever, under the following conditions •}'^^ 

"* Bally, p. 76. 

Robert, vol. 1, p. 272. 

Pariset, pp. 95; 96. 

Chervin: Examen Critique, p.. 80. 

Bancroft: Essay on Yellow Fever, p. 462 (note.) 

Bancroft: Sequel, p. 309. 
"^Moreau de Jonnes: Monographie Historique, etc., p. 341. 
"•* Berenger-Peraud, p. 84. 
"^Berenger-Feraud, pp. 85; 86. ^ 

^^8 Bally, Francois and Pariset, p. 61.. 

Robert, Guide Sanitaire, vol. 1, p. 272. 

O'Halloran, p. 45. 



SPAIN. 601 

In August, 1821, a boat left Tortosa, where yellow fever 
was epidemic, and reached Mequinenza on the 28th of 
the same month. One of the passengers, on reaching 
Mequinenza, was taken ill and was transported to his 
home in the town, where he died of yellow fever on the 
30th. Of nine persons who composed his family, seven 
contracted the disease and died. The malady spread to 
the inhabitants and caused much mortality. 

iMIJAS. 

1804. 

Mijas, fifteen miles southwest of Malaga, was infected 
by fugitives from that city in 1804. The disease did not 
spread to the inhabitants.^'^^ 

MONTE ALEGEE. 

1821. 

A family consisting of father, mother and two children, 
fleeing from Barcelona, arrived at Monte Alegre, October 
30, 1821. The father, taken ill on his arrival, died on 
November 3 ; the mother followed on the 21st. One of the 
children was also affected; the other escaped an attack. 
The disease did not spread beyond these cases.* 

MONTEJUGUE. 

1800. 

Eefugees from infected localities contaminated Monte-^ 
jugue in 1800. The disease did not spread to the in- 
habitants.^^^ 

"^Salamanca: Observaciones Medica sobre la Fiebre Amarilla, 

etc., Malaga, 1804, p. 5. 
* Bally Francois and Pariset, p. 99. 
""Rougeau, loc. cit. 



60« HISTORY OF YELLOW FEVER. 

MONTILLA. 

1803. 

A few cases of yellow fever, refugees from Malaga and 
other infected points, were observed in Montilla in 1803. 
The inhabitants escaped the infection. ^^^ 

1804. 

In 1804, Montilla had a population of 4,000.* It was 
contaminated in the following manner :^^^ 

A monk who had recently arrived from Malaga, 
was taken sick at Montilla, August 11, and died in five 
days. Other cases followed that of the padre. The houses 
where the deaths had occurred were closed and all persons 
having contact with the cases were isolated. September 4, 
another monk, a fugitive from Malaga, was attacked with 
yellow fever and died in a few days. A muleteer return- 
ing from Malaga fell victim to the same fate. From these 
foci, the disease extended to a large portion of the com- 
munity, but owing, it appears, to the energy of the san- 
itary authorities, did not work such havoc as elsewhere. 
December 15, the city was declared free from yellow fever. 

The mortality was as follows : Males, 616 ; females, 451 ; 
a total of 1,067. 



^^^ Berenger-Feraud, p. 74. 

* Chervin (Examen Critique, p. 5) says that the population of 
Montilla in 1804 was 14,000, and not 4,000; but as the 
majority of 'chroniclers place the numher at 4,000 and 
taking into consideration the fact that the present popula- 
tion of Montilla is only 15,000, we incline to the belief that 
Chervin was misinformed. 
"== Eager, p. 20. 
Fellowes, p. 478. 
Bally, p. 90 

'Chervin, Examen Critique, p. 5. 
Pariset, p., 86. 
Jackson, p. 22. 



SPAIN. 603 

MOEA. 

1821. 

In 1821, an inhabitant of Mora, a town on the Ebro, 
30 miles west of Tarragona, communicated with Tortosa, 
where yellow fever was prevailing. He was taken ill with 
the disease on his return home and died in a few days. 
The infection did not spread, being confined to this sol- 
itary case.* 

MORON DE LA FEONTERA. 

Moron de la Frontera, 32 miles from Seville, was visited 
twice by yellow fever and, in each instance, the mortality 
was heavy. 

1800. 

The great epidemic wave of yellow fever which passed 
over Spain in 1800, also reached Moron de la Frontera. 
A mortality of 1,854 is recorded.^^^ 

1804. 

In 1804, the first case in Moron de la Frontera was ob^ 
served September 15. The epidemic lasted until Decem- 
ber 12. Out of a population of 11,000, there were 2,000 
deaths. Of these, 1,300 were men and 700 women.^^^ 

MURCIA. 

1804. 

The ancient Moorish city of Murcia, 30 miles northwest 
of Cartagena, was infected by fugitives from the latter 
place in 1804. There was no diffusion of the disease.^^^ 

* Rapport lu a 1' Academie Royale de Medecine de Paris (Paris, 

1828), p. 86. 
^* Alfonso da Maria, p. 122; La Roche, vol. 1, p. 534. 
^»*Fellowes, p. 478; Bally, p. 90. 
""Bally, p. 90. 



604 HISTORY OF YELLOW FEVER. 

1810. 

Sporadic cases were observed in 1810. The inhabitants 
did not suffer.* 

1811. 

Cases were also imported into Murcia in 1811. There 
was no spread of the malady. ^^^ 

1812. 

A few sporadic cases, fugitives from infected localities. 

XONASPE. 

1821. 

Fugitives brought yellow fever to Nonaspe in 1821. 
There was no spread of the disease.^^^ 

OJOS. 

1821. 

During the series of epidemics of yellow fever in Spain 
from 1800 to 1821, sporadic cases, all refugees, were ob- 
served at Ojos. The chroniclers of the period do not 
specify the year. 

OLIVEEA. : 

1800. 

A few cases of yellow fever found their way into Olivera 
in 1800, but the infection did not spread to the in- 
habitants.^^^ 



* Bonneau and Sulpicy, p. 363. 

'^ Berenger-Feraud, p. 84; Bally, Francois and Pariset, p. 559. 

'" Bally, Francois and Pariset, p. 62. 

^Rougeau, loc. cit. 



SPAIN. 605 

OLOT. 

1821. 

A mattress-maker residing at Clot,* who made daily 
trips to Barcelona in the interest of his business, was 
taken ill on his return home, on October 26, 1821, and 
expired shortly afterwards. His son, who ministered to 
him during his illness, was not affected. The man's house 
was rigidly quarantined and no other case resulted. ^^^ 

PALMA. 

(See Balearic Islands). 

PALMA^R. 

Eefugees died at Palmar during the series of yellow 
fever epidemics in Spain in the beginning of the last 
century, but the exact date is not given by our authority. ■'^^" 

PASAJES.* 

1823. 

In 1823, yellow fever was introduced into Pasajes (also 
known as El Pasajes and Port du Passage) under the 
following conditions :^^^ 

* Chervin, Pariset, BerengernFeraud and other chroniclers call 
this place "Xlot," instead of "Olot." On a map of the 
environs of Barcelona, the locality is designated as "Olot." 
^^^Pariset: Histoire Medicale de la Fievre Jaune, etc., p. 86.. 
Chervin: Examen des Princrpes de rAdministration en Matiere 
Sanitaire, p. 51. 
^^ Second Report on Quarantine, p. 209. 

"^Audouard: Revue Medicale Francaise et Etrangere (Paris), 
1824, vol. 3, p. 224. 
Jourdain: Journal General de Medecine, 1824, vol. 86, p. 176, 
iMontes: Decadas de Med. y Cirug. Pract. (Madrid), 1827, vol. 

14, p. 321. 
Boisseau: Physiological Pyretology. Philadelphia, 1832, p. 335. 
Berenger-Feraud, p. 101. 



606 HISTORY OF YELLOW FEVER. 

The ship DonOrStiera, sailed from Havana, where yellow 
fever was prevailing, at the end of June, 1823, with a 
crew of fifteen and five passengers. The vessel had pre- 
viously been engaged in the slave trade between Africa 
and Havana. 

Ten days after leaving Havana, one of the crew died, 
the symptoms being ^'of a suspicous nature.-' The vessel 
reached Corunna, Spain, thirty-five days after her de- 
parture from Havana, and was subjected to ten days' 
quarantine, after which it left for Santander, where it 
remained six days, finally reaching Pasajes on August 2. 
No quarantine was interposed. 'The crew was discharged 
and the cargo disembarked between the 6th and 16th, 
and stored in warehouses in the burgs of Saint-Jean and 
Saint-Pierre, which together form the town of Pasejes. 
The population was then, 3,200 of which 2,000 were at 
Saint- Jean and 1,200 at Saint- Pierre. 

On August 15, nine days after the opening of the 
hatches, a customhouse employe who had been stationed 
on board the Donastiera was taken ill and died on the 
17th, with symptoms of yellow fever. 

On August 20, a carpenter who had been employed in 
making repairs to the vessel, was attacked and died on 
the 22nd. From the last date until September 1, six 
workmen engaged in removing rotten timbers from the 
hold of the vessel, and a huckster and two boatmen who 
had gone on board, were successively taken ill and died, 
making a total of eleven deaths in two weeks. The char- 
acteristic symptoms of yellow fever and the appearance 
of black vomit in nearly all the cases, left no doubt as to 
the true character of the disease. 

Pasejas is situated on the Bay of Biscay, near the 
French frontier, and yellow fever had never been observed 
there before. When the real state of affairs became pub- 
lic, the population recalling the horrors of the Barcelona 
epidemic of 1812, were thrown into consternation border- 
ing on terror, and by September 5th, 1,620 had fled pell- 
mell wherever they could. 

On September 12, a strict military sanitary cordon was 
established around the infected localities, but in spite of 



SPAIN. 607 

these precautions, the disease continued to spread. On 
September 16, yielding to popular clamor, the Donastiera 
was burned to the water's edge and her cargo, which had 
been stored in warehouses in the town, guarded by the 
military. 

The last case erupted September 25, but the sanitary 
cordon was not removed until October 23, when the in- 
habitants were permitted to return to their homes. But 
the goods from the Donasteria, which had been sequestered 
shortly after the outbreak of the epidemic, were not al- 
lowed to be placed on sale until January, 1824. 

There were 101 cases, of which 40 (25 men and 15 
women) proved fatal. 

This epidemic was the subject of much acjrdmonious 
discussions between the chroniclers of the period. 

PA'TEKNA DE LA EIBIEKA. 

1800. 

Yellow fever invaded Paterna de la Eibiera in 1800, re- 
sulting in 86 deaths. ^^^ 

1804. 

In 1804, Paterna de la Eibiera had a population of 
1,140. Yellow fever appeared in the town on August 30, 
and lasted until December 8, causing a mortality of 117, 
of which 72 were men and 45 women.^^^ 

PEDEAEA. 

1821. 

Eefugees from Seville died at Padrara during the epi- 
demic of 1821. The infection did not spread to the in- 
habitants.1^4 

^^^La Roche, vol. 1, p. 534. 

"^Fellowes, p. 478; Bally, p. 90. 

"* Bally, Francois and Pariset, p. 99. 



608 HISTORY OF YELLOW FEVER. 

PEDROCHES. 

1879. 

The bark Imogen^ from Rio de Janeiro, arrived at 
Pedroches June 7, 1879, with a crew of fifteen and forty- 
one passengers. Twelve cases of yellow fever, all fatal, 
had occurred on board during the voyage across the At- 
lantic. While the ship was in the quarantine basin at 
Pedroches, a case erupted on June 18, followed by two 
others. Our authority does not state whether these cases 
were fatal or not. There was no diffusion of the in- 
fection. ^^^ 

PENACERRADA. 

1804. 

Penacerrada, a village of 100 inhabitants, was invaded 
by yellow fever on September 28, 1904. From that date 
until November 16, there were 14 deaths, of which 9 were 
men and 5 women.* 

PORT MAHON. 

(See Balearic Islands). 

PUERTO DE SANTA MARIA. 

1800. 

Puerto de Santa Maria was infected by Cadiz in 1804. 
It had then a population of 20,000, ouf of which 3,493 
died from the pestilence/^^ 



"'Branco: Correjo Med. de Lisboa, 1879, vol. 8, p. 149. 
*Fellowes, p. 478; Bally, pp. 90; 449. 
^^ Bally, p. 75. 

Alfonzo da Maria, p. 122. 



SPAIN PUERTO DE SANTA MARIA. (J09 

1804. 

Four persons from Cadiz fled to Puerto de Santa Maria 
in 1804, and were taken ill with yellow fever shortly after 
their arrival. They infected the inhabitants, but the 
epidemic does not seem to have been severe, as the total 
number of cases and deaths is not given.^^^ 

1819. 

A fugitive from Isla de Leon brought yellow fever to 
Puerto de Santa Maria in 1819. The developments were 
unimportant. ^^^ 

1821. 

Several persons, who contracted yellow fever in Cadiz 
and Xeres de la Frontera, were taken ill and died at 
Puerto de Santa Maria in 1820. The inhabitants of the 
town were not affected. ^^^ 

1821. 

Yellow fever invaded Puerto de Santa Maria in 1821, 
but the attacks were so limited as scarcely to deserve the 
denomination of an epidemic. Details are not available.^"" 

PUERTO REAL. 

1800. 

In 1880, Puerto Real had a population of 1,000. Ac- 
cording to Alfonzo de Maria, the first case manifested 
itself on August 11, in the person of a youth, who died 
on the seventh day of the onset. His case w^as diagnosed 

^»^ Bally, p. 90; Bally, Francois and Pariset, p. 80. 

"* Berenger-Feraud, p. 90. 

"^Robert: Guide Sanitaire, vol. 1, p. 272; O'Halloran, p. 138. 
^ O'Halloiran, p. 70. 



610 HISTORY OF YELLOW FEVER. 

by the authorities as "ardent fever, caused by insolation."* 
Perez, Pariset and others, claim that the first case was 
that of a carpenter who had been on board the corvette 
Dauphin, from Havana, who was taken ill August 21 and 
died on the 27th. 

From these two foci, the disease spread far and wide, 
resulting in the death of 1,621 persons.^^^ 

1819. 

A few cases were observed in 1819. Some authorities 
place the mortality at 10, while others claim that the 
disease was more widespread. Authentic details are 
lacking.2C'2 

EEGEXS. 

1821. 

Eegens, situated five miles from Tortosa, must have 
been free from Stegomijaie Calopae in 1821, for, according 
to O'Holloran, not a single case erupted in the village, 
although many refugees from Tortosa who took up their 
abode there, died of yellow fever. Some of the inhabitants 
who communicated with the infected city was stricken, 
but those who remained aloof enjoyed total immunity 
from the disease.-^^ 

EICOTE. 

At some time or other, during the first years of the 
last century, yellow fever was brought to Eicote by 
refugees. The works we have consulted fail to specify the 
date. 

* "* * * la fiebre de ardiente por insolacion." 
="Alfonzo da Maria, loc. cit.; La Roche, yoL 1, p. 534; Chervin, 

Examen Critique, etc.. p. 34; Robert, p. 279; Pariset, p. 92; 

Perez, Theses de Paris, Xo. 127 (1825), p. 15. 
*" CherYin, Examen ■Critique, p. 47. 
^■^ O'Halloran, p. 122. 



SPAIN. 611 

KONDA. 

1800. 

In 1800, Eonda was infected by refugees from near-by 
localities. The outbreak was confined to a limited area, 
resulting in 20 cases, of which 19 proved fatal.^^^ 

1803. 

A few cases were also observed in 1803. No details are 
obtainable.^^^ 

1804. 

The first person whose case gave suspicion of the exist- 
ence of yellow at Eonda in 1804, was Maria de Eio. She 
was attacked on July 27, and died on August 4; the 
disease was denominated "black erysipelas" by the medi- 
cal attendant. She vomited black matter before death; 
and is said to have recollected that two persons from 
Malaga lodged at her house some time previous. The 
woman was ignorant of their character, or the state of 
their health at the time. 

Francisco Euiz, another inhabitant of Eonda, was taken 
ill on September 4, and died on the 7th, He became in- 
disposed in four or five hours after his return from 
Malaga; he was deeply jaundiced, and matter which he 
vomited was of a black color. Besides Euiz, a lady ar- 
rived from Malaga, on the 19th of August, at the house 
of her mother and was taken ill with yellow fever shortly 
afterwards. 

From these foci, the disease pursued a slow course until 
the first days of October resulting in about 50 deaths.^^^ 



^Chervin: Examen Critique, p. 88. 
"^ Ibid. 

^Jackson, loc. cit., p. 23; Cliervin, Examen Critique, p. 88; Bally, 
Francois and Pariset, p. 78; Eageir, p. 20. 



612 HISTORY OF YBLLOW FEVER. 

EOQUETAS. 

1821. 

Roquetas, a hamlet on the Ebro, opposite Tortosa, was 
contaminated by refugees from that city in 1821. The first 
victims were two women, named De Juari. After these, 
the village barber was stricken and then the mayor. The 
infection did not spread to the inhabitants, being confined 
to these four imported cases.^^^ 

ROTA. 

1800. 

Rota, which had 6,000 souls in 1800, was contaminated 
that year by refugees from Cadiz and Isla de Leon. Many 
fled, but the disease seems to have been imbued with un- 
usual virulency, for out of the small remaining popula- 
tion, there were 1,116 deaths.^^^ 

1804. 

Yellow fever invaded Rota in 1804, but no reliable de- 
tails are obtainable. Perez gives a resume of twenty- three 
autopsies, but does not touch upon the historical phase 
of the epidemic.^^^ 

SAINT ELOY. 

During the first years of the nineteenth century, yellow 
fever was imported to Saint Eloy. No details or dates 
given by the authorities we have consulted.^-'^^ 



2°^ O'Halloran, p. 21. 

^* La Roche, vol. 1, p. 534; Alfonzo da Maria, p. 122. 

==°^ Perez: Journal General de Medecine, 1820, vol. 71, p. 3. 

=^°;Seoond Report on Quarantine, p. 209. 



SPAIN. 61 S 

SAN ANDERO. 
1813. 

In the autumn of 1813, being the close of the Peninsular 
War, sporadic cases of yellow fever appeared in the depot 
barrack in San Andero, in Spain, and after the Christmas 
holidays, became numerous. The troops were removed to 
a healthy situation, and the epidemic was soon under 
control. 

Out of about 700 persons who were exposed to the in- 
fection, 50 were attacked and 11 died.^^^ 

Our authority does not attempt to give the source of 
infection, but as yellow fever ravaged several cities of 
southern Spain in 1813 (Cadiz, Gibraltar and Medina- 
Sidonia) and the events of the Peninsular War rendered 
rigid quarantines impracticable, we can safely incrimi- 
nate one of the above named foci in this importation. 

SALOU. 

1821. 

On July 28, 1821, the JSfuestra Senora de Begoma ar- 
rived at Salon from Barcelona, where yellow fever was 
prevailing. Owing to the high tide, the crew was unable 
to land. This was fortunate for the inhabitants of the 
village, for the captain of the little craft was taken ill 
with yellow fever during the night and died the following 
morning. The boat was immediately quarantined by the 
health authorities. A sailor, taken ill on the day of the 
captain's death, died on August 2. The disease was not 
communicated to the inhabitants of Salou.^^^ 



^Second Report on Quarantine, p. 235. 

^Chervin: Examen des Principes de rAdministration Sanitaire, 
p. 57. 



614 HISTORY OF \'ELLOW FEVER. 

SAX GEKYAISO. 

1821. 

A refugee from Barcelona died of yellow fever at San 
Gervaiso in 1821. Only a few cases resulted from this 
infection.-^^ 

SAX JUAX DEL PUERTO. 

1804. 

Yellow fever was introduced into San Juan ( which had 
then a population of 3,176) by refugees from neighbor- 
ing cities on September IT, 1801. The epidemic lasted 
until December IT, resulting in 219 deaths, of which 136 
were men and 83 women.^^^ 

SAX LUCAR DE BARAMEDA. 

1800. 

San Lucar de Barameda, which had a population of 
18,000 in 1800, lost 2,303 from yellow fever that year.^^^ 

1819. 

In 1819, sporadic cases were observed. Xo authentic 
details are obtainable.^^^ 

1821. 

The last appearance of yellow fever in San Lucar de 
Barameda took place in 1821, when a few cases, probably 
refugees, caused some apprehension. There was no dif- 
fcsion of the disease.-^^ 

=^ O'Halloran, p. 88; Bally, Francois and Pariset, p. 434; Chervin, 

Examen Critique, p. 200. 
^*Fellowes, p. 478. 

^La Roche, voL 1, p. 534; Bally, p. 75. 

^^ Medico-Chirurgical Journal and Review, 1821, vol. 2, p. 439. 
^"Robert, loc. cit., vol. 1, p. 272. 



SPAIN. 615 

SAN KOQUE. 

1804. 

In 1804, a resident of San Roque went to Algeziras, 
where yellow fever was prevailing, to see his son, who was 
ill. On his return home, he was taken ill and infected 
five persons living in his immediate neighborhood. From 
these foci, the disease spread throughout the town.^^^ 

SANS. 

1821. 

A resident of Sans went to Barcelona on business dur- 
ing the epidemic which devastated the latter city in 1821. 
He remained but a few hours. On his return home, he 
was taken ill and died in a few days. His wife, who 
nursed him, also contracted the malady and died. It was 
afterward proved that this man's wife often accompanied 
him to Barcelona, and it was no doubt on one of these 
trips that she was infected, as none of the five children 
of the couple, nor their servants or friends who visited 
them, were attacked. No other inhabitant of Sans con- 
tracted the malady.^^^ 

SARRIA. 

1652. 

Was it yellow fever which ravaged Sarria in 1652? 

In 1652, a pestilence "of an unknown character" raged 
in Barcelona and was brought by refugees to Sarria. 
This epidemic is commented upon by Rochoux.* The 
little suburban village was almost depopulated. To com- 
memorate their escape from the scourge, the survivors 
erected a singular monument in the gardens of the Capu- 

* Berenger-Feraud, p. 78. 
^^^'Chervin: Examen des Principes, etc., p, 47. 

Bally, Francois and Pariset, p. 50. 

Pariset: Histoire Medicale de la Fievre Jaune, pp. 50; 107. 
♦Rochoux: Recherches sut les Differentes Maladies qu'on 
Appelle Fievre Jaune. Paris, 1828, p. 75. 



616 HISTORY OF YELLOW FEVER. 

cins at Sarria. This monument, even to this day, is an 
object of curious pilgrimage to the tourist and the inhabi- 
tants of Barcelona and neighboring Tillages. The alle- 
gorical figures are of terra cotta and represent a proces- 
sion in solemn march, the largest personages being quar- 
ter life-size, others much smaller. The processionists are 
grouped around a church. In their midst is a personage 
who appears to have been suddenly stricken with the 
scourge. All about him are people either dying or dead. 
The moribund are being attended to in their last moments 
by surpliced friars. A peculiar feature of this group is 
that all the personages have bleeding sores, either on 
the sides, the nape of the neck, the arms or legs. Two 
of the stricken ones are vomiting. One of the latter, 
whose features are painted yelloio, is ejecting hlack matter 
from the stomach, while the other, whose distended 
cheeks show that his mouth is full, has placed a hand 
over the oriface, as if in a vain effort to stop the escape 
of the fluid. A monk supports his head with one hand 
while with the other he offers him a draught out of a 
cup containing a beverage which he seems to coax him 
to take. 

Near this remarkable group is a small two-story edifice, 
covered with a shroud, which is open on one side. 
Through this opening can be seen eleven skeletons habited 
in monkish garments^ — three in the first story, four in 
the second and four in the basement. At the base of this 
mausoleum, is the following scription, written in the 
picturesque language of Catalonia: 

NOMS DELS ONSE RELIGIOUS 

QUE MORIREN DE PESTA^ 

EN LO ANY 1652, 

ASSISTIN EN LO SPIRITUAL Y TETMPORAL AL POBLE 

DE SARRIA ESSENT AFFLIGIT DE TAL CONTAGI ; 

Y SON ENTERRATS BAIX EST PANTAON.* 

* Translation: 
"Names of the eleven religious who died of the pest in 1852, 
while bringing spiritual and temporal assistance to the 
inhabitants of Sarraia, afflicted with this contagion; they 
rest beneath this pantheon." 



SPAIN SARRIA. 61? 

Although Spanish archives are silent as to the real 
character of this pestilential visitation, the pantheon 
above noted certainly leads to the suspicion that a malady 
bearing two of the pronounced characteristics of yellow 
fever — black vomit and jaundice — devastated Barcelona 
and Sarria in 1652. The running sores, however, pre- 
clude the diagnosis of yellow fever. But it does not fol- 
low that these latter symptoms were really present. The 
exalted temperament of the Catalonians may have imbued 
the artist (or artists) who moulded this remarkable group 
with ultra extravagant ideals, and induced him; to add 
the running sores to the other symptoms for effect. The 
Spaniards are proverbially fond of coups de theatres^ and 
do not hesitate to give their imaginations free rein tO' 
effect a soul stirring climax, even at the sacrifice of truth. 

As the real diagnosis of this epidemic has never been 
satisfactoryily established, we do not include it in our 
chronology, but simply give it a niche in this volume as 
one of the "curiosities" of epidemiology. 

1800. 
Five persons, fleeing from Barcelona, died from yellow 
fever at Sarria in 1800. The inhabitants were not con- 
taminated.^^^ 

1821. 

A doctor of Sarria, on the eve of being married, went 
to Barcelona with his fiancee on September 7, 1821. The 
couple spent the day in going from shop to shop making 
purchases. They were married the following day and 
took up their residence in Sarria. On the 9th, the day 
after the ceremony, the bride was taken ill with yellow 
fever and died on the 13th. The husband, stricken on 
the 11th, died on the 20th. There were altogether 18 
deaths in the village, all in persons who had been to 
Barcelona. Those who remained at home did not con- 
tract the malady.^^^ 

2^» La Roche, vol. 1, p. 534. 

^^Chervin: Examen des Principes de rAdministration, etc., p; 48. 
Bally, Francois and Pariset, pp. 50; 57. 



618 HISTORY OF YELLOW FEVBR. 

SEVILLE. 

Historical Resume. 

Seville, the Romula of Julius Caesar, is one of the most 
artcient cities of Spain, and has been made famous in 
song and story from the time it was the capital of a 
Mohammedan emirate to the age of de Musset. Even to 
this day, a glamour of romance pervades this historic 
place, whose old Moorish houses, Gothic cathedral and 
famous aqueduct, are the only vestiges of an old-time 
splendor, when it boasted of a population of 600,000 souls. 
Its decadence began with the capture of the city by Fer-, 
dinand III in 1248, when 300,000 Moors fled from the 
sabres of the cruel Castillians. The discovery of Amer- 
ica gave Seville renewed energy and for a time it was 
again flourishing, but the superior advantages of the port 
of Cadiz induced the government to order the galleons to 
be stationed at the latter place, and the decline of the 
ancient metropolis of Andalusia was rapid from that date. 
In 1800, the population was only 80,568. During the one 
hundred and eight years which have elapsed since, the 
increase has been slow, the estimated population of the 
town in 1908 being 148,315. 

Yellow Fever Years. 
1649 (not authentic) ; 1800; 1801; 1819; 182L 

Summary of Epidemics. 

1649. 

According to Spanish tradition, yellow fever was ob- 
served in Seville as early as 1649, but authentic documents 
are lacking to substantiate this statement. According to 
the most reliable authorities we have consulted, yellow 
fever had never invaded the ancient Moorish city previous 
to 1800. But there is a strong possibility, nevertheless, 
that the disease was imported to the Spanish coast prior 
to that date. Before it was superseded by Cadiz, the port 
of Seville was the principal shipping and receiving point 
for the extensive commerce between Spain and her colo- 



SPAIN SEVILLE. 6l9 

nial possessions in the New World, and it is natural to 
surmise that the dreaded Antillean pestilence was im- 
ported within its walls, but, owing to its mildness or its 
sporadic nature, was unnoticed by the historians of the 
period, whose time was more occupied in watching and 
recording court intrigues than in making history. 

The only modern author who refers, in a roundabout 
way, to the Seville epidemic of 1649, is O'Halloran, in a 
small monograph published in 1821 ( Yellow Fever m 
Andalusia in 1820, p. 165 ) , in which he gives Lind as his 
authority. A perusal of the works of the famous English 
physician fails to throw any satisfactory light on the 
subject. 

1800. 

The first epidemic of yellow fever in Seville of which 
there is authentic record, took place in 1800. The origi- 
nal cases were observed August 23, in the suburb of 
Triana, which is separated from the city proper by the 
Guadalquivir Kiver, and inhabited principally by bull- 
fighters, seamen and smugglers. Smugglers from Cadiz 
are said to have infected Triana. Communication between 
both banks of the river being uninterrupted, the infection 
was soon brought to the suburb of Los Humeros,, opposite 
Triana, also inhabited by seamen and the working classes, 
whence it was propagated throughout the town. 

Seville had then a population of 80,568. As is always 
the case when compiling statistics showing the ravages 
of great epidemics, authorities differ as to the total num- 
ber of cases and deaths.^^^ The majority, however, unite 
in placing the cases at 76,488 and the deaths at 14,685. 

^VLa Roche, vol. 1 ,pp. 534; 536; 538. 
Bally: Typhus d'Amerique, p. 72. 
Caisergues: Memoire sur la Contagion de la Fievre Jaune. 

Paris, 1817, pp. 190; 214. 
Fellowes: Pestilential Disorder of Andalusia, p. 421. 
Arejula, p.. 434. 
Alfonzo da Maria, p. 122. 
Berthe: Precis Historique de la Maladie qui a Renee en 

Andalousie en 1800. Paris, 1800.. p. 64. 



620 HISTORY OF YELLOW FEVKR. 

Fellowes (p. 421) gives the following tableau of deaths: 

From August 23 to the end of the month 165 

In September 2,106 

In October .\ 9,236 

In November 1,223 

Dates not specified 1,955 

Total deaths from August 23 to November 30. .14,685 

La Eoche (p. 538), in commenting on the above mor- 
tality, states that when we read the statement here re- 
corded, authentic as it appears to be, we can with dif- 
ficulty divest ourselves of the idea of error having crept 
in somewhere. "Not that I feel disposed to swell the 
mortality to 20,000, as was done by Dumeril (Humboldt, 
779), and thereby diminish the ratio of recoveries; but I 
am inclined to regard it as probable that the number of 
those stricken down with the real malignant yellow fever 
did not reach the amount mentioned." The idea of an 
epidemic evtending its baneful influence to all but 4,000 
in a population of 80,000, La Eoche finds difficult to 
reconcile with the facts known respecting the diffusion of 
the same disease elsewhere. He thinks it is more natural 
to presume that in the number of cases recorded, are in- 
cluded many of the other and milder complaints. Should 
this be true, the proportion of deaths to recoveries would 
be larger than stated; while the number of cases might 
still be very large in proportion to the population. To 
this opinion, he is the more inclined, because, so far as 
he could ascertain, the Spanish physicians, of those times 
at least, were not noted for accuracy in matters of diag- 
nosis, and their success in the treatment of the disease 
had not usually been such as to induce the belief that they 
would lose but 1 in 5.21 during a wide-spreading and 
highly malignant epidemic. 



SPAIN SEVILLE. 621 

1801. 

In 1801, yellow fever reappeared in Seville. The malady 
affected principally those who had fled the preceding year. 
There were in all 1,100 cases, of which 660 proved fatal.^^^ 

1819. 

The epidemic of 1819 broke out in the quarter of Santa 
Cruz, where it was brought by a woman who had fled 
from Cadiz, and who died on September 18 in the home 
of a friend in Baraba Street. The friend contracted the 
malady and in his turn contaminated those who visited 
him. By this means, the fever was disseminated through- 
out the quarter, where it raged until November 21, re- 
sulting in 546 cases and 217 deaths, out of a population 
of 1,650. The disease was confined exclusively to the 
Santa Cruz quarter.^^^ 

1821. 

, A few cases were observed in 1821. The developments 
were unimportant.^^^ 

SITGES. 

1821. 

Sitges is located on the Mediterranean, eighteen miles 
from Barcelona. On August 1, 1821, a woman who had 
been in the latter place returned to her home in Sitges 
and was taken ill with yellow fever. She died on the 5th. 
Three persons who had nursed her were immediately dis- 
patched to the country by the health authorities, but none 



222 Bally, p. 77; Berenger-Feraud, p. 71; Keating, p. 81. 

223 La Roche, vol. 1, p. 536, and vol. 2, p. 387; Berenger-Feraud, 

p. 90; Chervin, Examen Critique, p. 11; Ootens, Decad.. de 
M€d. et de Cirug. Prac (Madrid), 1828, vol. 4, p. 68. 
22^ O'Halloran, p. 70. 



622 HJSTORY OF YELLOW FEVER. 

of them contracted the disease. !No other case occurred 
in the town.^^^ 

TABAECA. 
1804. 

The diminutive island of Tabarca, in the Mediterranean, 
five miles south of Alicante, was infected by yellow fever 
from the latter place in 1804. The mortality was small.^^*^ 

TOBAEKA. 

1811. 

Yellow fever was carried as far as Tbbarra, in Murcia, 
in 1811. There was no extensive spread of the disease.'^^^ 

TOEEE DEL MAE. 

1804. 

Fugitives from Malaga died from yellow fever at Torre 
del Mar in 1804. The inhabitants of the village were not 
affected.228 

TOEEE MOLING. 

1804. 

Persons who had communicated with Malaga died from 
yellow fever at Torre Molino in 1804. The villagers who 
remained at home were not affected.^^^ 



-^ Chervin, Examen des Principes de 1' Administration, p. 58: 

Berenger-Feraud, p, 94. 
=^Ball3% pp. 90; 449. 

^-^ Bally Francois and Pariset, p. 560; Berenger-Feraud, p. 84. 
2=« Bally, p. 87. 
^^^Fellowes, pp. 181; 182. 



62$ 



TOETOSA. 

Historical Resume. 

The picturesque city of Tortosa, in Catalonia, on the 
Ebro, 22 miles from its mouth, and 63 miles southwest of 
Tarragona, occupies a romantic niche in history. Origi- 
nally a Moorish stronghold, it was wrested from the in- 
fields by Louis le Debonaire in 811, but was recaptured 
by the Moors and became a nest of pirates. Eugenius III 
proclaimed a crusade against the place, and it was re- 
taken by the Christians in 1148. In 1149, the Moors 
made a desperate effort to regain possession of the city, 
but were frustrated, partly through the bravery of the 
women. In 1798, the French invaded the city. Popula- 
tion, 24,702. 

Summary of Epidemics. 
1821. 

In 1821, for the first time in its history, Tortosa was 
invaded by the Saffron Scourge and suffered one of the 
most destructive epidemics on record. The population 
was then 15,000, of which 10,000 fled when the real nature 
of the malady became known to the inhabitants. 

The facts of this epidemic are as follows :^^^ 

The first case developed in the person of a soap 
dealer named Curto, who had communicated with Bar- 
celona on August 1, and arrived at Tortosa on the 4th. 
He was taken ill on the 6th, in the soap manufactory in 
the Calle de Cerced and died on the 11th in the country, 
where he had been transported by the health authorities. 

The second case was that of a sailor named Puich, who 
belonged to the brig Ventura. This vessel sailed from 
San Feliu de Guixols, Spain, early in July, and was 

^ O'Halloran, p. 110; Chervin, Examen des Principes, etc., p. 66; 
Bally, Firancois and Pariset, p. 34. 



624 HISTORY OF YELLOW FEVER. 

detained fifteen days in the Ebro Eiver, for want of water 
to float her to the city* There was no epidemic disease 
at the port of departure and it is said that Puich held 
no communication with Curto. He was, therefore, in- 
fected at Tortosa. He was taken ill on August 11. He 
was visited on the 13th by two physicians of Tortosa, 
who unhesitatingly pronounced his disease to be yellow 
fever. When black vomiting and other unequivocal symp- 
toms of the Antillean pestilence made their appearance, 
the unfortunate sailor was forcibly taken from his bed 
at eight o'clock at night, compelled to dress himself, and 
with a rope around his neck (for the emissaries of the 
health authorities were afraid to touch him ) , was dragged 
by four armed soldiers to a lazaretto in the country, at 
which he arrived after a march of three hours. The laz- 
aretto, being unoccupied, was forced open, and the un- 
happy and helpless victim, without assistance or even 
water to allay his thirst, was left to his fate for the 
remainder of the night, without even a bed on which to 
repose. He died on the 15th. 

The third case was that of a sailor who had arrived 
with the soap-maker, Curto, from Barcelona, who died 
a few days after the onset of the malady. 

Cases then appeared in various parts of the city, mak- 
ing slow progress, until August 29, when thirty persons 
were suddenly seized with the symptoms of the dreadful 
scourge, all of whom died within a short time after being 
attacked. i 

Panic, terror and despair seized the populace. Of thfe 
15,000 persons which constituted the population of Tor- 
tosa, 10,000 fled. It was well that this wholesale exodus 
took place, for of the 5,000 who remained, 2,356 perished. 

The epidemic came to an end about the middle of 
October. 



* "Hacia 15 dias que se hallaba en el rio." — ^Official Report of 
Tortosa Board of Health. 



SPAIN. 625 

1870. 

For almost half a century, yellow fever was kept out 
of Tortosa. That year occurred the memorable epidemic 
of Barcelona, and the disease was imported from the 
latter place to the former, on September 17. From that 
date until November 30, when the last case was observed, 
sporadic cases erupted here and there, but at no time was 
the disease epidemic. There were in all 41 cases, of which 
32 proved fatal. Of those attacked, 23 were men and 
18 women; of those who died. 20 were men and 12 
women.^^^ 

TOTANA. 

1811. 

In 1811, yellow fever was imported to Cadiz from the 
Canary Islands, and thence to the neighboring cities in 
Southern Spain. A few cases were observed at Totana, 
but the disease did not spread to the inhabitants.^^^ 

TRIAjNA. 

(A Suburb of Seville, which see). 

TRIBUJENA. 

1800. 

During the general epidemic of yellow ever which 
devastated Spain in 1800, Tribujena was invaded by the 
pestilence and lost 68 inhabitants.^^^ 



^'"^ Ferandez y Domingo: .Siglo Medica, 1873, vol. 20, p. 261. 
^^2 Bally, Francois and Pariset, p. 559; Berenger-Feraud, p. 84. 
"^ La Roche, vol. 1, p. 534. 



626 HISTORY OF YELLOW EEYER. 

TUEEIANO. 
1804. 

Turianno, where nearly all the bread consumed in 
Malaga was baked in the beginning of the last century, 
had uninterrupted communication with that city during 
the great epidemic of 1804, but none of the inhabitants who 
remained at home contracted the disease. Most of the 
persons who brought and deliyered the bread at Malaga, 
contracted yellow ferer and died on their return to their 
native town, but in no instance did they infect others.^^* 

A similar state of atfairs prevailed at Alcala de los 
Panaderos, near Turriano, where were also located numer- 
ous bakeries which supplied Seville with the '^staff of 
life." The chroniclers of the period attributed this sing- 
ular immunity to have resulted from the burning of 
aromatic herbs in the bakers' ovens, but it is useless to 
observe that had all the spices of the Molacca Islands 
been incinerated, Turriano would not have escaped in- 
fection if the Stegomyia Calopiis had established itself 
within the precincts of the town. 

UBRIQUE. 

1800. 

The epidemic of 1800 also invaded Ubrique, 46 miles 
northeast of Cadiz. Only a few cases, all refugees from 
the latter place, were observed.^^^ 

UTREEA. 

1800. 

A regiment of infantry from Cadiz infected Utrera in 
1800, resulting in 1,689 deaths.^s^ 

-^* Bancroft: Essay on Yellow Fever, p. 460. 
=^="Rougeau, Theses de Paris, 1827, No. 119. 
^•'La Roche, vol. 1, p. 534; Chervin, Examen Critique, p. 54. 



SPAIN. 627 

VALENCIA. 

1870. 

A sailor arrived at Valencia from Barcelona, where 
yellow fever was prevailing, in the latter part of Sep- 
tember, 1870. He took lodgings at No. 3 Calle Euy Dom 
Pedro, where he developed the disease. On October 1, 
other sailors who had come from Barcelona took lodgings 
at No. 23 of the same street, and were taken ill with yel- 
low fever. Quarantine against Barcelona was then es- 
tablished and no other cases appeared. The inhabitants 
of Valencia were not affected.^^'^ 

VEJEE DE LA FKONTERA. 

1800. 

In 1800, refugees from Cadiz died of yellow fever at 
Vejer de la Frontera. There was no diffusion of the 
disease.^^^ 

VELEZ MALAGA. 

1804. 

Velez Malaga, 14 miles east of Malaga, was infected hy 
refugees from; the latter place in 1804. Out of a popu- 
lation of 12,700, there were 5,245 deaths from yellow 
fever, of which 3,496 were men and 1,749 women. The 
first case was observed August 20 ; the last, December 4. 
The greatest mortality took place on September 24.^^^ 



23^iSiglo iMedica, 1871, vol. 18, p. 630; Deutsch Klinik, Berlin, 

vol. 23, p. 117. 
^'^■Rougeau, loc. cit.; Chervin, Examen Critique, p. 49; Pariset, 

Obs. sur la Fievre Jaune, pp.. 67; 76. 
^^^Fellowes, p. 478; Bally, pp. 88; 90; Berenger-Feiraud, p. 76. 



628 HISTORY OF YELLOW FEYER. 

VEEA. 

1804. 

On September 17, 1804, the wife of a marine officer 
arrived at Vera from Cartagena, where yellow fever was 
committing fearful ravages, and was taken ill on the 
20th of the same month. Almost all the members of the 
household contracted the malady and died. The neigh- 
boring houses were soon contaminated, but rigid measures 
were instituted by the health authorities and the infected 
quarter completely isolated. The infection was thus re- 
stricted to the original focus, resulting in 208 deaths out 
of a population of 4,000. Of the fatal cases. 111 were 
men and 97 women. The epidemic came to an end on 
January 4, 1805.^40 

1811. 

Vera was infected by a man who arrived from Seville 
in the latter part of 1821, and who died of yellow fever 
on the same day. From this focus, the malady diffused 
itself throughout the town.^^^ 

VIGO. 

1856. 

Yellow fever was imported into Vigo in April, 1856. 
The first cases appeared among the prisoners at the penal 
institution. Sotelo, the officer in charge, states that he 
carefully studied the cases, but gives only a resume of 
the clinical features of the disease. The epidemic lasted 
for "more than nine months," the last death occurring 
in January, 1857. There were 833 cases, of which 106 
proved fatal.242 

2*°Fellowes, p. 478; Bally, p. 90; Eager, loc. cit.; Berenger- 

Feraud, p. 77., 
=^" Bally, p. 97 (foot-note). 
^■^Sotelo: Sieiglo Medica, 1858, vol. 5, p. 100. 



SPAIN. 629 

1889. 

On September 7, 1889, cases of "alleged" yellow began 
to be officially observed in the town, although it is said 
that the disease had been sporadically present for some 
time previously. The origin of this outbreak has never 
clearly established and many doubt that this was actually 
an epidemic of yellow fever. The Portugese assert that 
it was, while the Spanish government as vehemently de- 
clared it was not. About 1,000 persons in Vigo and the 
neighboring coast villages were attacked, and about 10 or 
12 per cent, of these died. Northerly winds and the cool 
weather caused the fever to subside, and it had entirely 
disappeared before the end of September.^^^ 

A search through Spanish papers and official docu- 
ments of the period fails to throw any satisfactory light 
on the subject. We looked carefully for records of the 
alleged epidemic which the U. S. Consular representa- 
tive claims to have ravaged Vigo and "neighboring sea- 
coast towns," but find nothing authentic. It is doubtful 
whether even the bulletin given out by the United States 
Public Health authorities is authentic. It was probably 
merely a statement made on hearsay, as we can find no 
corroboration of same. 

VILLA MARTIN. 

1800. 

A solitary case of yellow fever, resulting in death, was 
observed in Villamartin in 1800. It was probably im- 
ported from Seville, 43 miles distant.^^^ 

1804. 

In 1804, Villamartin had a population of 1,880. The 
first case was observed October 5. From that date until 
December 25, 168 deaths are recorded, of which 93 were 
men and 75 women.^^^ 

=^*^U. )S. Public Health Reports, vol. 4, 1889, pp. 286; 370.. 
^ La Roche, vol. 1, p. 534. 
2*=Fellowes, p. 478. 



630 HISTORY OF 'i'ELLOW FEVlR. 

VILLAXUEVA DEL AEISCAL. 

1800. 

A few cases of yellow fever, undoubtedlY imported from 
Seville, occnrred in Vilalunueva del Ariscal in 1800. The 
population of the town was not affected.-^^ 

YILLASECA DE LA SAGEA. 

1821. 

Villaseca de la Sagra was infected by refugees in 1821. 
The disease did not spread.-^' 

XEEES DE LA FEOXTEEA. 

Historical Resume. 

Xeres de la Frontera (commonly called Xeres or 
Jerez), is a famous town of Andalusia, 16 miles by rail 
northeast of Cadiz. The Asta Fegia of the Eomans, it 
owes its modern name to the Moors, who fought a seven 
days' battle near the town in 711, in which they defeated 
Eoderic, the last of the Goths. The present fame of 
Xeres rests upon the delicious wine known as sherry, 
which it exports in enormous quantities to all parts of the 
world. 

Yellot^' Fever Years. 

1800; 1801; 1808; 1813; 1819; 1820; 182L 

Summary of Epidemics. 

1800. 

Fugitives from Cadiz introduced yellow fever into 
Xeres de la Frontera about the middle of August, 1800. 

^ Rougeau, loc. cit. 

-*' Berenger-Feraud, p. 94. 



SPAIN. 631 

The first death took place August 25. From that date 
until the close of the epidemic, out of a population of 
42,000, there resulted 32,000 cases, of Avhich 14,000 
proved fatal.^^^ 

1804. 

In 1804, fugitives from Cadiz died from yellow fever 
at Xeres. From September 23 to December 1, there were 
71 deaths, of which 63 were males and 8 females. The 
inhabitants of the town were not affected.^^^ 

1808. 

An individual from Cadiz died from yellow fever at 
Xeres in 1808. Eigorous prophylatic measures were taken 
to protect the large prison, and were successful until 
near the decline of the outbreak. At that point some 
prisoners slipped away, but were captured and returned 
to their cells. They brought back yellow fever with them, 
and so terrible was its effect within the prison walls 
that only a few of the convicts escaped death. {Eager ^ 
loc. cit.j p. 21). 

1813. 

In 1813, ^\Q individuals from Cadiz died from yellow 
fever in Xeres. There was no diffusion of the disease.^^^ 

1819. 

^ gypsy and her daughter, originally from Isla de 
Leon, are accused of having brought yellow fever to Xeres 

' 2*« Bally, p. 75. ^ " 

La Roche, vol. 1, pp. 534; 536. 

Chervin, Examen 'Critique, p. 57. 
. Proudfoot, Edinburgh Medical Journal, vol. 28, p. 295. 

Caisergues, loc. cit., p. 214. 

Pariset, Preces Historique, p. 163. 
==*^ Fellowes, p. 478; Bally, p. 90. 
^ Cheirvin, Examen Critique, p. 70, 



632 HISTORY OF YELLOW FEVER. 

in 1819. Chervin {Examen Critique, p. 68) denies tMs, 
but the official report of the Xeres health authorities as- 
sert that such was the case,* an opinion also shared by 
Berenger-Feraud (p. 901). Whether the Bohemians were 
guilty or not, it is, neyertheless, true that the first cases 
were observed in the persons of two soldiers who had 
taken lodgings at the house of the women located in the 
Calle de Pavia, and who died shortly afterwards. From 
this focus, te disease spread to other quarters of the town, 
but the advent of the cool season prevented a general 
diffusion of the malady. Out of a population of 45,000, 
there were 1,262 cases, of which 408 proved fatal.^^^ 

1820. 

On August 10, 1820, a woman arrived at Xeres de la 
Frontera from Cadiz, where yellow fever was prevailing, 
and hired herself as a servant to a woman named Kameiro 
in the Calle Torneria. Feeling indisposed she only re- 
mained two days at this house and repaired to the abode 
of an old friend in the Calle de Arcos. She remained 
there two days, when she was removed to the hospital de 
la Sangre, where she shortly afterwards died. 

On the 14th, 15th and 16th of the same month (August) , 
eight persons living in the house in Calle de Arcos and 
two in the house of the Kameiro woman, were attacked 
by "a mysterious disease." Five of these patients died. 

The official records state that there were 201 cases, of 
which 102 proved fatal, but Jackson {Remarks on the 
Epidemic Yellow, etc., p. 137), states that the mortality 

* En la Calle de Pavia se bospodo una gitana procedente de la 
iciudad de San-Fernando con una ibija que trais la en- 
fermedad, de la qui murio a pocos dias, y la communico. 
251 La Roche, vol. 1, p. 536. 
Berenger-Feraud, p. 90. 
Pariset, Observations, p. 66. 
Chervin, Examen Critique, p. 67. 

Bonneau and Sulpicy: Recherches sur la Contagion de la 
Fievre Jaune,. Paris, 1823, p. 302. 



SPAIN. 6S3 

was in reality much higher, for only those who were 
buried without the corporate limits of the town were 
included in te dead list. Private burial was obtained for 
many, and such were not registered as yellow fever 
deaths.252 

1821. 

. The first case of yellow fever in Xeres in 1821, erupted 
in the perso^n of a man living in the Plaza de la Con- 
stitucion, who was attacked on August 13 and died August 
20. There is no authentic record whence the man came. 

The second case, a child four years old, w^as observed in 
Porvera Street a month later, September 13, and died 
on the 18th. The source of infection could not be traced. 

The third case, that of a young girl, erupted on Sep- 
tember 15, in a house a few^ yards distant from the sec- 
ond case. The patient recovered. In this particular in- 
stance, the infection was traced to Puerto de Santa Maria, 
w^here yellow fever was epidemic, w^here the girl had re- 
mained two days before coming to Xeres. 

From these foci, the disease spread to other quarters 
of the towm. Our authorities do not give the total number 
of cases and deaths, from w^hich fact we infer that the 
malady did not attain the proportions of an epidemic.^^^ 

XIMENA DE LA FEONTEEA. 

1804. 

Ximena de la Frontera, 46 miles east of Cadiz, was in- 
fected by fugitives from the latter place, on October 
27, 1804. The last case was observed December 30. 
Out of a population of 7,500, there were only fifty deaths 

^^^Periodico de la Sociedad Quirurgica de 'Cadiz, 1822, p. 24. 

La Roche, vol. 1, p. 536. 

Jackson, p. 137. 

O'Halloiran: Yellow Fever in Andalusia in 1820, p. 153. 
^^ O'Halloran, p.. 70. 

Ferran: Annales de Medecine Physiologique, Paris, 1825, vol. 
7, p. 298. 



634 HISTORY OF YELLOW FEVER. 

(29 men and 21 women), which naturally leads to the 
belief that the disease was not communicated to the in- 
habitants of the town, but was confined solely to 
refugee. -'^"^ 

YECLA. 

1812. 

In 1812, after the battle of Salamanca, the French 
army which occupied Andalusia retreated through the 
Kingdom of Valencia. The fourth diyision of this corps 
reached the Kingdom of Murcia, where yellow fever was 
preyailing, about the 1st of October. They passed through 
the town of Ziezar (which was also infected), and camped 
on the outskirts, where they remained about two days. 
They reached Jumilla where yellow fever was also 
present, but did not enter the town, on account. of its 
unhealthiness. Contintiing their march, the soldiers 
finally reached Yecla, 11 miles north of Murcia, on the 
Jumilla Eiver, where they concltided to camj). Some of 
the soldiers were soon taken ill and the disease diagnosed 
as yellow fever by the army surgeon. A baker attached 
to the division died on the 9th. This case was rapidly 
followed by others. Between October 8 and 15, abotit one 
hundred deaths occurred. The malady then gradually 
subsided and became extinct by the latter part of 
October.^^^ 

ZIEZA. 

1811. 

Zieza (or Ciezar), erroneously called Zuzar by Beren- 
ger-Feraud, was infected by refugees during the epidemic 
wave of yellow fever which passed over southern Spain 
in 1811. ^o details are given by our authority.-^^ 

=^Fellowes, p. 478. 

Bally, Francois and Pariset, p. 79. 
2^Peyson: Journal General de Medecine, 1820, voL 71, p. 343. 

^ Berenger-Feraud, p, S3. 



SPAIN. 635 

1812. 

Two refugees from Cartagena brought yellow fever to 
Zieza in the beginning of September, 1812. Almost the 
entire population fled to the country, but there were still 
some sick left when the French army passed through the 
town on October 1. They found the place deserted, with 
unburied corpses in many of the houses. The troops did 
not stop at this place, but they were, nevertheless, infected 
and carried the disease to Yecla (q. v.), where many of 
the soldiers perished from the prevailing sickness.^^"^ 

-" Berenger-Feraud, p. 85; Peyson, loc. cit., p, 343. 



HISTORY 



OF 



YELLOW FEVER 



IN 



NORTH AMERICA. 



6Sd 



Proofs that Yellow Fever Is an American Product 

AND Was Unknown to Europeans Before the 

Time op Columbus. 

The history of yellow fever in America dates from the 
second voyage of Columbus, 1493. Before that time the 
disease was presumably unknown to the civilized world. 
Traditional accounts given by the Aztecs and other Indian 
tribes of the countries and islands washed by the Gulf 
of Mexico, state that a disease possessing all the 
characteristics of yeUow fever committed fearful rav- 
ages among the tribesmen long before the discovery of 
America, being known under the name of Cocolitzle and 
Matlazahuatl by the aborigines. We have not the slight- 
est doubt of the identity of this affliction with the malady 
now known as yellow fever, as the pest was unknown 
to Europeans before the colonization of the New World; 
but Science, after over four hundred years of investi- 
gation, has failed to establish a connecting link between 
the two diseases. 

Finlay makes a valuable contribution to the literature 
on the subject of American origin of yellow fever in the 
Climatologist* in which, after reviewing w^hat others 
have said about the origin of the disease, and giving his 
own views, goes on ^to show that yellow fever was known 
to the American Indians before the discovery of America. 
Dr. Finlay's conclusions are based upon his interpreta- 
tion of a philological study on the the names of "America" 
and "Yucatan," by the Bishop of Yucatan, Dr. Crescencis 
Carillo y Ancona. While reading this scholarly work. 
Dr. Finlay came across a quotation from the "Chumayel 
manuscript," which reads as follows: 

^' There was black vowiit^ which began to occasion deaths 
among us in 1648." 

This statement immediately suggested the idea that 
among the Indian manuscripts of Yucatan, might be 



6i0 HISTORY OF YELLOW FEVER. 

found the evidence that was wanted to prove that yellow 
fever was not unknown to the American Indians before 
the advent of Columbus. Accordingly, the matter was 
submitted to the learned Bishop himself, acquainting him 
with the state of the question and begging for information 
on the following points : 

Whether among the Maya documents that he had ex- 
amined in the course of his other researches, any data 
had been met confirmatory of Dr. Finlay's conjectures, 
or throwing light on the subject of the epidemics called 
cocoUfzJe, which, according to Herrera (Decada 4, Lib. 
9, Cap. 6), used to attack the Mexican Indians on the 
coast of Xew Spain before the arrival of the Spaniards. 

In answer to this request, the Eev. Bishop wrote a 
most interesting and instrucive letter, containing a full 
discussion of the subject, and valuable data not to be 
found in the literature of the period. Dr. Finlay's article 
in the CJimatologist was inspired by this important com- 
munication, which is here reproduced, and we hold that 
it has such an important bearing upon the C[uestion ttnder 
discussion, that we summarize it in these pages. 

After proving, tipon the best testimony, that Yucatan, 
until the year 161:8, had been pronounced by all the 
Spanish writers a most salubrious country, exempt from 
the diseases that prevailed in other places, no epidemic 
of any kind having been observed in it from the com- 
mencement of the Spanish colonization in 1517 tmtil 
1618, the Eev. Bishop Carrillo concludes that the dis- 
ease called cocoUtzJe by the Mexicans, and which pre- 
vailed annually at Vera Cruz before the Spanish invasion, 
did not habitually manifest itself in Yucatan. Eegard- 
ing the disease, he calls attention to the circumstance 
that, from Herrera's own account, it is easily seen that a 
distinction was made by the Mexicans between the local 
endemic, properly designated under the name of cocolitzle, 
and a broader application of the same term, qualified 
by some expletive such as "general" or "universar- when- 
ever it was used to designate other epidemic invasions 
that extended over the whole country, as subsequently 



NORTH AMERICA. 641 

happened with small-pox. The local endemic, the 
Gocolitzle proper, existed at Vera Cruz, "some years more 
violent than others;" and the reason why the Spaniards 
found so large a population on that coast was that, on 
occasions when the cocolitzle had been particularly severe, 
Montezuma used to send 8000 families from the interior 
to repeople the coast, exempting them from taxes during 
a term of years and granting them other privileges. This 
cocolitzle may, therefore, have been yellow fever, but at 
any rate it did not occur at Yucatan between the years 
1517 and 1748. He next goes on to prove the epidemic 
of 1648, alluded to as "black vomit" in the "Chumayel 
manuscript," was in reality yellow yever ; and does so 
very effectively by reproducing a most remarkable 
description of the epidemic by an eye-witness, the Yuca- 
tan historian, Fray Diego Lopez de CogoUudo, who was 
himself attacked by the disease. This account is so 
graphic, so rich in sagacious remarks, and so acucrate 
in its clinical details, that it well deserves to be given 
here. It runs thus : 

"1648. Shortly after the commencement of the solar 
year, in the month of March, the sun appeared for sev- 
eral days to be eclipsed, the air being so thick that it had 
the appearance of a mist or condensed smoke. This was 
so general that every part of the land, from Cozumel to 
Tobasco, offered the same unwholesome condition.* * * 
In the city of Merida, especially towards evening, when 
the winds generally set from the sea, a bad smell was 
brought with it that could scarcely be borne, and pene- 
trated everywhere. The cause of this smell was un- 
known until a Spanish vessel happened to run aground 
over an immense heap of dead fish near the shore. It 
was from these fish, which were being washed ashore by 
the tide, that the smell had proceeded, extending as far 
as the city, and even beyond. In April and May some 
sudden deaths occurred, which caused alarm in the city 
of Merida. At the beginning of June the scourge of the 
peste commenced in the town of Campeche, and in a 
few days became so severe that the place was completely 



642 HISTORY OF YELLOW FEVER. 

ravaged. * * * The roads to Campeche were guarded 
for fear that the contagion should spread ; but if the Lord 
guards not the city what shall human efforts avail ! With 
this fear of Divine justice the month of July passed, until 
towards the end a few persons began to sicken, dying 
very soon; but the disease was not considered epidemic 
until the month of August. With such violence and 
rapidity were the people attacked, big and small, rich 
and poor, that in less than eight days the whole popula- 
tion were sick at the same time, and many citizens of 
the highest rank and authority died. * * * While 
the city was thus afflicted by this calamity, never before 
seen since this countri/ was conquered 'by the Spanish 
nation, permission was asked that the image of Our Lady 
of Itzamal might be brought. * * * Very great was 
the tribulation, such a calamity having never been experi- 
enced before. * * * In other countries epidemics oc- 
cur as a common evil which attacks uniformally all the 
people, but such was not the case in Yucatan, which 
caused greater confusion. It teas impossible to say what 
the disease was, for the physicians did not recognize it. 
In most of the cases the patients were taken with a most) 
severe and intense headache, and pains in all the bone& 
of their bodies, so violent that their limbs felt as if torn 
asunder or squeezed in a press. A few moments after 
the pains came on a very intense fever which in most 
instances produced delirium, though not in all. This was 
followed by vomiting of blood, as if putrefied, and of such 
cases very few survived. 'Some were attacked with dis- 
charges from the bowels of a bilious humor, which 
being corrupt occasioned dysentery without vomiting, 
while others again made violent efforts to vomit without 
being able to discharge anything, and many suffered the 
fever and pains in the bones without any of the other 
symptoms. * * * In the majority the fever seemed 
to remit completely on the third day ; they would say that 
they felt no pains whatever, the delirium would cease, the 
patients conversing in their full senses, but they were 
unable to eat or drink anything; they would continue 



NORTH AMERICA. 643 

this for one or several days, and while still talking and 
saying they were quite well, they expired. A great num- 
ber did not pass the third day, the majority died on the 
fifth, and very few reached the seventh, excepting those 
who survived, and these were mostly advanced in years. 
The most robust and healthy of the young men were most 
violently attacked and died soonest. * * * Although 
a great many women were taken sick, the disease was less 
severe in them than in men. * * * Some cases oc- 
curred in which the patient passed the fever in a sleep, 
until they recovered, having no one to administer remedies 
to them. In houses of large families there were scarcely 
any one to attend to the sick or to fetch the sacraments 
for them. This spiritual difficulty was remedied by the 
charity of the priests, both secular and regular, who went 
about the street by day and night carrying with them the 
Holy Viaticum and the Holy Oils, and visited the houses 
to administer the same to such as required them. * * * 
When the laity began to improve, the disease broke out 
among the priests. Of eight members of the Jesuits col- 
lege, six died. * * * Of our own Order (Franciscans) 
twenty died in the city. Almost all the heads of insti- 
tutions and persons of highest ranks, both ecclesiastics 
and seculars, were carried away by the epidemic. * * * 
While it lasted in its full intensity among the Spaniards, 
the Indians were not attacked, excepting those who lived 
with the former, or who, having visited the city, left it 
already touched by the disease; most of these died in 
their villages, but did not communicate their illness to 
those who attended them. This emboldened the Indians 
to declare that the scourge was a punishment of God, 
and that only the people of cities and town were attacked 
for their ill-treatment to the Indians. * * * a. deceit- 
ful Indian spread the report that all the Spaniards in 
Yucatan would die, and the Indians would be left by 
themselves. * * * Finally, this man was taken up 
and the rumor ceased. * * * Soon, however, did our 
Lord undeceive the Indians of their presumption, for a 
few days after the above occurrence the illness broke out 
in many of the Indian villages, causing fearful havoc, as 



644 HISTORY OF YELLOW FEVBR. 

was to be expected, considering their want of comfort 
or medicine. * * * The disease' continued over the 
whole country during the space of two years. * * * 
Few that lived in this land or visited it in the course of 
those tw^o years escaped being sick, and it rarelp hap- 
pened that any one died of a second attack after having 
recovered from the first. All remained pale as ghosts', 
without hair, many lost their, eyebrows, and all were so 
pulled down that even after two days' fever with mod- 
erate pains (such as happened to myself), it was many 
days before they could recover- their strength. * * * 
In the year of 1650, on our way to visit the province of 
Guatemala * * * having to pass through an exten- 
sive pine wood * * * we observed that since the year 
of 1648, in which the epidemic had commenced, some 
pestilential air or other noxious influence had dried up 
all the full grown pine-trees, * * * 'only the young 
ones remained with life. I then reflected that of the 
young children who were attacked by the peste in Yucatan 
only a few had died, as compared with the adults." 
{CogoJIudo-Histona de Yucatan^ Lihro, XII, Capitiilo 
XII; XIII; XIV). 

The Eev. Bishop, after this quotation, states that the 
Spanish historian finding himself at a loss to classify or 
to name the curious malady which, after the lapse of over 
a century, affected the Spaniards of Yucatan, found him- 
self constrained to give a minute account of its symptoms 
and circumstances; whereas, the ^'Chumayel manuscript" 
only needs one sigie word, both graphic and appropriate, 
in order to record the occurrence of the epidemic, by its 
special name, in the corresponding chronological note 
w^hich it has been his good fortune to give to the learned 
world in the fac-simile that accompanies his Philological 
Study on the names of America and Yucatan — Uchci 
xekik hoppci cimil toon 1618 anos — which means: There 
was black vomit, which began to cause death among us in 
the year 1618. 

Even without knowing the Maya language, read care- 
fully that line of text and observe the second word, xekik. 



NORTH AMERICA. 64-5 

In the Dictionary of Don Juan Pio Verez, you will find 
it rendered by vomito prieto^ vomitur sangre (black vomit, 
to vomit blood). The words that follow means: '^And 
we ourselves began to die — " referring to the Indians; for 
which reason Cogolludo has said that at the commence- 
ment of the epidemic, only the Spaniards were attacked, 
but subsequently the Indians also began to suffer. 

This philological demonstration must be continued in 
the Bishop's own words: 

''Nothwithstanding that from this statement alone of 
the Chumayel manusGript, I infer that the vomito negro 
was known to the indigenous historians, though new to 
the Spaniards of Yucatan, this would only constitute a 
conjecture, more or less grounded; whereas, what is re- 
quired, as you say, is a decisive fact. This brings us to 
the essential and culminating point of the present letter." 

"The Maya manuscripts that I possess^ like ail the 
sacred books of the ancient Yucatecos or Chilam-halam 
books, as they are vulgarly known, have precisely for their 
principal object the recording of chronological notes con- 
cerning their feasts to their gods, wars, pestilences, 
famines and invasions by the Spaniards. They are chron- 
icles and calendars. I therefore proceeded to examine 
them more particularly in such parts as concord with 
the Chumayel regarding the seventeenth century and the 
occurrence of the great epidemic, and find the following 
conclusive statement in the Tzimin manuscript (which I 
have so named because it proceeds from the Tzimin 
Indians (Tzimincah), between the folios 16 (verso) 
and 17 : 

"In English: ^In the 4th ahau (year of the Mayas), 
at the expiration of a katun (their century) which is 
counted towards the well of Chichenitza, at the placing 
of the stone katan, arrival of Kuk, arrival of Yaxum 
(mythological and historical characters ivho gave their 
names to the epochs) arrival of Kantenal, OCCUEEED 
THE AEEIVAL OF BLACK VOMIT FOE THE 
FOUETH TIME, arrival of Kukulcan, after the Ytzaes, 
at the fourth placing and signification of the katun.' 



646 HISTORY OF YELLOW FEVER. 

"This statement throws much light on that of the 
Chumayelj for, in speaking of the same epidemic cor- 
responding to the year 1648, it says most positively that 
it teas the fourth time that it had visited this country ; and 
considering that since the discovery in 1517 until the said 
year of 1648, in which the epidemic broke out, it had 
never been seen by the Spaniards, it must follow that 
the three previous invasions had occurred before the 
discovery." 

The Eev. Bishop goes on to say that so true is this, that 
the same historians he has quoted before to prove the 
constant healthiness of the climate of the Yucatan penin- 
sula, and that in it loere not experienced the disease that 
occurred in other lands — all are equally agreed in stating 
that great epidemics had been suffered in Yucatan before 
the discovery, thereby conrming the words in the Tziman 
manuscript. 

The Eev. Fray Don Diego de Landa, who, it must be 
remembered, was a missionary in Yucatan during the first 
epoch after the discovery, expressed himself in the follow- 
ing terms : 

"Various calamities were experienced in Yucatan in 
the century hefore the conquest, hurricanes, pestilences, 
wars, etc. * * * There came all over the land certain 
pestilential fevers, which lasted twenty-four hours, and 
after the patients would smell and break out full of 
worms, and from this pestilence a great number died, and 
a great part of the crops could not be gathered ; that after 
the epidemic had ceased they had a period of sixteen good 
years, during which their quarrels and dissensions were 
renewed, so that one hundred and fifty thousand men 
were killed in wars, after which they were quieted, made 
peace and rested during twenty years, and when they 
were attacked Ijy a jjestilence of large boils, which rotted 
their bodies with great fetidness, so that their limbs would 
drop off in pieces in the course of four or five years." 
{Landa, Relacion de las co\sas de Yucatan. . Ano de 
1566). 

The same account is given by Herera [Decada IV, Lihro 



NORTH AMERICA. 64? 

Xy Cap. J 111) and other historians, and it must be par- 
ticularly remembered that the Kev. Bishop Lauda had 
at his disposal a great number of Mai/a manuscripts;, 
painted skins, and other historical relics of the Yucatan 
people; a notorious fact, which is attested both by his 
important work, just quoted, and by the accusation 
brought up against him of having burned such documents 
in the auto da fe that took place in Man. 

The author holds, therefore, as sufficiently proven and 
for a certain and unquestionable fact, that the Indians 
of Yucatan suffered from the vomito negro as an epidemic, 
before the advent of Columbus, and consequently yellow 
fever is a disease properly belonging to America. 

There is another statement, though only of an accessory 
character, is the Maya manuscript, which the Kev. Bishop 
found in the Prescription Books of the Indians^ of which 
he possessed several ancient copies, in the Maya language. 
In almost all these books, the following prescriptions 
appears : 

. /^U cacal xekik ti unic, mu hach chad, maix kiki hay u 
kah yhacna/^ which nieans: ^medicine for the vomiting of 
blood for the persons who discharge it; not properly of 
a red color, nor resembling red blood, but like a liquid 
mixed toith soot/' 

If one will notice the last word, yhacna, and consult 
the dictionary of Don Juan Pio Peres, he will find that 
it is rendered by Hollin which in Spanish signifies "a 
black substance, thick and oily, which the smoke leaves 
in chimneys." 80 that kik hay u kah y hacna means 
"black vomit, like an infusion of soot." Thanks, there- 
fore, to this unexpected application of the Kev. Bishop 
Carrillo's extensive philological and bibliographical learn- 
ing, the vexed question of the origin of yellow fever and 
the true nature of the early epidemics experienced by the 
Spaniards, on their arrival to these parts of America., ever 
since the days of Columbus, may be considered as defin- 
itely settled. 

Dr. Finlay states that notwithstanding that the chrono- 
logical system of the Mayas and the concordance of their 



648 HISTORY OF YELLOW FEVER. 

dates with our Christian era are but imperfectly under- 
stood, the learned bishop, in a subsequent letter, informed 
him that he had other grounds for his assertion and abso- 
lute conviction that the epidemic of black vomit, referred 
to in the Tzimin manuscript, is the same that we find 
recorded in the Chumajjei under the date of 1648. Se 
wrote Dr. Finlay that although the quotation from the 
Tzi)ni)i manuscript does not contain the date (expressed 
in years of the Christian era), the book commences its 
chronological notes with the year ^'1593,'- so written, in 
the hand of the Indian author and with the same figures 
that we now use i folio 1, line 2). If we follow the text, 
page after page, and without omiting a single word, it is 
observed that no invasion, of ''vomiting of blood'' is re- 
corded until folio IT is reached; here the author for the 
first time mentions such an invasion, adverting that it 
was the fourth that had occurred. Xow, that it is a 
proven fact that after the year 1593, and even since the 
discovery of Yticatan in 1517, no epidemic of hlaclx vomit 
had occtirred until 1618, to this same year must cor- 
respond the fourth epidemic mentioned in the Tzimm 
7n an u script, and the three previous ones must have taken 
place before the year 1593, at which time chronological 
record begins. 

If the Tzimin text does allude to "black vomit" or 
yellow fever, before the invasion which the author quali- 
fies as the fourth, he does so not in a historical sense, 
but as a calamity to be dreaded in evil times. It must 
be remembered that these CJiiJam heJam books are cal^ 
endars, which not only contain chronological and his- 
torical notes, but also predictions that in a prophetic 
style had been made in their ancient times. This one, 
for instance, is a literrl translation from the same Tzimin 
man uscript : 

, "At the end of the 2ud ahau * * * it will happen 
that the people will have to seek laboriously for food as 
far as the shores of the Sv^a, eating the young leaves of 
plants, and with setting of the 'katmn, days will come 
•when great vomiting of Wood will afflict the people, and 



NORTH AMERICA. 649 

all joy will cease; then, in order to find food, it will be 
necessary to solve enigmas that will be proposed; and 
after those troubles are passed, after the katum, days of 
consolation will come.'' 

The fact that the Indians introduced in their prognos- 
tics of evil days the threat of vomiting of hlood, concludes 
Dr. Finlay, is another proof that the disease had been 
well known to them since a long time, and precisely under 
its epidemic form, not as the endemic that it has now 
become. 

It is thus paramount, from Dr. Finlay's important 
work, that yellow fever is an American product, was un- 
known to Europeans previous to the discovery of America 
by Columbus, and that Mexico, Central America and the 
West Indies may be considered as the original cradle of 
the awesome scourge. 



650 

CANADA 

History of Yellow in Canada. 

Canada enjoys the distinction of being the northern- 
most part of the American Continent where yellow fever 
has been observed. It is true that only sporadic im- 
ported cases of the disease have appeared within its 
domain, but had the Stegomyia Calopus been present at 
the time of these isolated manifestations, there is no doubt 
that a different story would have been told in these pages. 

In most works on epidemiology, Quebec, which is in lat- 
itude 46° 49" 6'", is given as the northernmost point in 
America where yellow fever has ever been imported. 
Such was, until very recently, also our belief, as will be 
seen by referring to page 63 of this volume, where we give 
Quebec as the most northern port in the Western Hemi- 
sphere where yellow fever has made its appearance.* 
While ''nosing about'' musty times and cobwebby docu- 
ments, we came across an old work by the distinguished 
French naval surgeon Keraudren, published in 1823. 
This valuable contribution to epidemiology is entitled 
De la Fievre Jaune Ohservee aux Antilles et siu^ les Vais- 
seauQO, Consideree Prinoipalement Sous le Rapport, de sa 
Transmission. Kreaudren, who was then Physician-in- 
Chief of the French Navy and Inspector General of the 
Health Department of the Navy, gives an interesting 
account of the outbreak of yellow on board the Tarn^ 
which became infected at Martinique in 1819.; At that 
period, whenever practicable, as soon as the terrible dis- 
ease manifested itself on board a ship attached to the 
French squadron, orders were at once received to set sail, 
for a colder clime, the point of refuge being generally 
either New Foundland or the islands of Saint Pierre and 
Miquelon, which lie off the south coast of the former. 
Keraudren states that, thanks to this wise precaution, 
the lives of many seamen were saved, for, as the infected 
vessel approached the northern seas, the disease gradually 
abated, generally ceasing altogether before reaching its 



CANADA. 651 

destination. A sojourn of a few weeks was then sufficient 
to purify the ship. 

Kreaudren informs us {loc. cit., page 18), that the 
TarUj of the French West Indian Squadron, left Marti- 
nique July 15, 1819. Two days later, a sailor was 
stricken with yellow fever and died the following day. 
On July 28 while in 33° 34' north latitude, four seamen 
were taken sick Avith yellow fever, followed the next day 
by six others. Two of these patients died, one on the 
fourth and the other on the fifth day after being attacked. 
Two died while the Tarn was actually in the harbor of 
Saint-Pierre, one on the seventh and the other on the 
tenth day after the onset of the malady. 

Saint-Pierre-de-Miquelon which is in latitude 47° 30', 
is therefore the most northern point in America where 
yellow fever has ever been observed. The disease was 
not communicated to the shore nor to the other vessels 
in the harbor, but had the same conditions which pre- 
vailed at Martinique, the original point of infection, ex- 
isted at Saint-Pierre-de-Miquelon, the importation would 
undoubtedly have been followed by disastrous results. 
This point is incontestably upheld by the fact that, al- 
though yellow fever ceased entirely while vessels infected 
in the West Indies or other southern latitudes were in 
the harbors of Saint-Piere, Miquelon or New Foundland, 
many instances are recorded where the disease reappeared 
with renewed energy when these same vessels returned to 
to the southern seas, before any communication what- 
ever with the shore. This phenomenon is attributed by 
Keraudren to the torrid heat of the southern latitudes; 
we, basking in the lime-light of the twentieth century 
knowledge, phlegmatically attribute it to the re-awaken- 
ing of the Stegomijia Calopus, whose sphere of misdi- 
rected usefulness had been nullified by the rigors of a 
boreal clime. 

We have found it amusing, when analyzing the theories 
of the thousands of learned epidemiologists of the past who 
have written ab libitum about the transfission of yellow 
fever, to observe how nicely their views dovetail into the 
mosquito theory of the glorious twentieth century. Ac- 



652 HISTORY OF YELLOW FIVER. 

cording to what thev consider incontestable proof that 
the disease, in such and such an instance had been trans- 
mitted by the wind, foul odors, old clothes, personal con- 
tact, casks of sugar and other odds and ends, the ear- 
marks of the calopus can be distinguished without the 
aid of a microscope and what was deemed impenetrable 
darkness suddenly becomes unclouded daylight. 
Verily, times do change. 

CHRONOLOGY OF YELLOW FEVER IX CANADA. 



1805. 


Quebec. 


1812. 


Quebec. 


1819. 


Saint-Pierre and Miquelon. 


18G1. 


Halifax. 


1864. 


Quebec. 


1878. 


Halifax. 


1880. 


Prince Edward Island. 




Bij Localities. 



Halifax. 1861; 1878. 
Quebec. 1804; 1812; 1864. 
Prince Edward Island. 1880. 
*aint-Piere and Miquelon. 1819. 

NOVA SCOTIA. 

HALIFAX. 

Yellow Fever Years. 

1842; 1861; 1878. 

Summary of Importations. 

. 1842. 

The Case of the Yolage} 

The British ship, Volage, was commissioned at Chat- 
ham, England, August 2, 1841, and sailed for the West 
Indies on January 2, 1842, calling on her way at Madeira 
and Bermuda, and remaining some time at the latter 



CANADA. 653 

place to refit. She anchored at Port Royal, Jamaica, on 
March 3, 1842, and remained there until the 26th of 
April ; she then sailed for Santa Martha and Carthagena, 
Colombia, and returned to Port Royal on the 12th of May. 
On the 19th she again took her departure for Colombia, 
where she arrived on the 23rd, and where she stopped 
eight days at Chagres, revisiting afterwards Carthagena 
and Santa Martha. This cruise occupied nearly a month. 

In the month of March, April and May, 1842, a, few 
cases of fever occurred which were of a mild character, 
and jdelded readily to the customary remedies. These, 
however, proved the precurors of an alarming outbreak 
of yellow fever, which commenced on the 18th day 
of May, and continued to spread, at first slowly, but after- 
wards rapidly and extensively amongst the officers and 
crew. 

Two cases, which terminated fatally, with yellow suf- 
fusion ^nd black vomit, occurred on the 25th of June, at 
Port Royal. There were then 17 cases on the sick list, 
exclusive of four at sick quarters. An immediate change 
to a cooler 'climate was thought advisable, not only for 
the recovery of those already seized, but absolutely neces- 
sary to arrest further progTess of the disease. Orders 
were, therefore, given to sail on the following morning 
for Halifax, Nova Scotia, proceeding via the Florida 
Channel. 

In spite of the ship having gone to a higher latitude, 
the disease advanced with increased force ; numerous fresh 
cases were added daily to the sick-list, and continued to 
be so even for some time after her arrival at Halifax, and 
did not completely cease until "all hands" were landed 
on Navy Island. 

It is difficult to come to a perfectly satisfactory conclu- 
sion as to when the fever originally broke out on the 
Volac/e, but it is evident that the primary infection was 
Chagres, Carthagena or Santa Martha, where the fever 
first seriously presented itself, and where the disease 
is endemic. 1 



654 HISTORY OF YELLOW FEVER. 

It will be perceiYed that the fever had gone on un- 
checked for nearly three months. The cases at Halifax 
were as virulent as those which took place at sea. 

That the infected Stegornyia Calopus never left the 
vessel, is proved by the fact that two officers who came 
on board to assist in nursing the sick, were taken ill 
within four days, and that two visitors who were only 
on board an hour or two, having been exposed to the same 
cause which operated on the two officers, were also 
stricken. 

Outside of these four cases, no other inhabitant of Hali- 
fax contracted the disease. 

1861. 

In the summer of 1861 — a very sickly yellow fever 
year — many ships of war of the British West Indian 
Squadron arrived at the port of Halifax, Nova Scotia, 
with cases of yellow fever on board. Some of the ships 
had suffered very disastrously during the voyage. The 

history of these importantion is as follows:^ 

« 

The Case of the Firehrand. 

The ship Firehrand arrived at Halifax from Jamaica, 
on July 4, 1861, after a passage of twelve days. There 
were then seventy-nine of the crew on the sick list — all 
fever cases. Ten deaths had occurred during the voyage 
from Port Koya|. Many of the sick were moribund. All 
the sick were at once transferred to a hulk moored off 
the naval hospital, and the convalescents and others sent 
to a storehouse in the dockyard. There were fifteen con- 
valescents, thirty convalescing and thirty-four seriously 
ill at the time. 

Several fresh cases occurred subsequently, and two 
were fatal, with black vomit. Besides these deaths in the 
hospital on shore, sixteen took place amongst the sick 
in the hulk. From the commencement of the disease, the 
Firehrand lost forty-nine of her crew out of one hundred 
and seven attacked. ^ 



CANADA. 655 

The Case of the Spiteful. 

The Spiteful arrived at Halifax on August 16, 1861, 
from the Bahamas, which she had left seven days before. 
Eleven deaths had occurred on the passage, and forty-six 
cases were on the sick list on axrival ; two died that night. 
The sick were at once sent to the hulk, and the conval- 
escent and the well to the dockyard. Some of these 
sickened with the fever on shore, and were then trans- 
ferred to the hulk. Altogether thirty-three sick were 
treated at Halifax, and of these, twelve died. The Spiteful 
lost in all thirty-six of her crew, out of eighty-eight 
attacked. 

The Case of the Racer. 

The Racer arrived at Halifax from Nassau on Septem- 
ber 3, 1861. During the passage, nineteen cases and five 
deaths occurred. Several fresh attacks took place after 
arrival. The total number of attacks among the crew of 
this ship was sixty-one, of which twenty proved fatal. 

•' The Case of the Jason. 

The Jason reached Halifax on September 2, 1861, from 
the Gulf of Mexico, which she had left sixteen days before 
in consequence of fever having broken out on board. 
During the voyage forty-six fresh cases and ten deaths 
took place. On arrival at Halifax, all the sick were sent 
to a building in the dockyard. A good many fresh attacks 
occurred after arrival The total number of attacks among 
the crew was seventy-nine, and seventeen proved fatal. 

Recapitulation of Cases at Halifex in 1861. 

Firebrand 28 16 

Spiteful 33 12 

Racer 42 5 

Jason ? ? 

; 103 33 



656 HISTORY OF YELLOW FEVER. 

Five vessels in all having an aggregate crew of 855, 
were found to be infected with yellow fever on their 
arrival at Halifax in 1861. Of this number, 499 were 
attacked and 162 died. It is interesting to note that not 
a solitary case of yellow fever occurred among any of 
the people about the dockyard at Halifax, or in any other 
inhabitant of the town. This proves that the Stcgomyia 
CaJopus did not migrate to the shore. 

1878. 

In 1878, H. M. S. Bullfinch, from the West Indies, had 
a large number of yellow fever cases while in the hai'bor 
of Halifax. The mortality was heavy.^ The outbreak 
was confined to the original source of infection. 

PRINCE EDWARD ISLAND. 

Charlottetowx. 

1880. 

'"A vessel from the West Indies" had two cases of yel- 
low fever while in the harbor of Charlottetown, in the 
month of. June, 1880. Two deaths resulted from the out- 
break.'* 

QUEBEC. 

Yellow Fever Years. 

1805; 1812; 1861. 

Summary of Importatioxs. 

: 1805. 

One of the most noteworthy outbreaks of yellow fever 
in Canada took place at Quebec in 1805. Whence the 
infection came, authorities are silent, but they all agree 
that it was a genuine manifestation of the disease. 
Quebec then carried on a considerable trade Avith the West 
Indies and was probably contaminated by some of the 
not over-clean vessels plying between the two localities. 



CANADA. 657 



What makes the incident still more remarkable, is the 
fact that the fever was confined solely to the 59th Regi- 
ment, not a single inhabitant of the quaint French town 
contracting the disease. There were in all 55 cases, of 
which 6 proved fatal.^ 

In the same old medical journal where we gathered the 
above facts,^ is the relation of a strange epidemic which 
ravaged Montreal in 1799, and which, it is claimed, came 
from Quebec. In the fall of that j^ear, the Asia^ a large 
troop ship, arrived at Quebec from the Cove of Cork, 
having the 41st Regiment and two companies of the 6th 
on board. The transport was crowded, and not over- 
clean, and some recruits from' a prison ship were 
suspected of having introduced the fever on board. Im- 
mediately on the Asia's arrival at Quebec, the men were, 
transferred from the ship to bateaux and sent up the 
river to Montreal. Scarcely were they settled in quar- 
ters, when a '^malignant putrid fever" broke out. Num- 
bers of the men and many inhabitants died. Entire 
families fled from the town, and the impression the pes- 
tilential fever made on the people was so forcible, that 
for two years afterwards the inhabitants of Montreal 
shunned the approach of a soldier. 



1812. 



Berenger-Feraud^ states that yellow fever was observed 
at Quebec in 1812. The learned epidemiologist gives no 
further details, and the logical conclusion is that it was 
probably a solitary case on board the proverbial "vessel 
from the West Indies." Had the disease obtained a foot- 
hold on shore, such men as Bally, Chervin, Laroche, Man- 
son, Clemow, Sternberg, Gorgas, Finlay and scores of 
others who have written at length on the history of yellow 
fever, would certainly not have allowed such a notable 
incident to remain unnoticed. 



658 HISTORY OF YELLOW FEVER. 

1864. 

The third and last appearance of yellow fever at 
Quebec took place in 1864. In August of that year, the 
ship Montgomery from Nassau, one of the Bahama Islands 
(West Indies), arrived at the Canadian port. Yellow 
dever was epidemic at Nassau when the ship sailed, and 
there had been several deaths from the disease during 
the voyage. On August 15, a man by the name of Mac- 
Clusty, who lived in a house opposite the wharf where the 
Montgomery was moored, was taken ill with yellow fever 
and died on the 19th. The infection did not spread.^ 

It is not stated whether or not MacClusty visited the 
Montgomery, but as he contracted the fever and no other 
case manifested itself, either on the vessel or at Quebec, 
the natural inference is that he did. 

Saint-Pierre and Miquelon. 

Description. 

Saint-Pierre and Miquelon is a French colony, off the 
southeast of New Foundland, composed of the islands 
of that name and the islands of LangJley and Isle-au- 
Chien. The importance of Saint-Pierre lies in the fact 
that it is the western terminus of three Atlantic cables. 
Population of the colony, 4,748, of which 3,743 reside on 
Saint-Pierre, 776 on Miquelon and Langley, and 499 on 
Isle-au-Chien. 

Saint-Pierre-de-Miquelon, so called to distinguish the 
town from Saint-Pierre, Martinique, is the capital of the 
colony. It is on the southeast side of the island of Saint- 
Pierre, is compactly built of stone and has a good harbor. 
Population, 3,187, or almost the entire population of the 
island. 

' Summary of Importation. 

1819. 

. The Tarn^ attached to the French West Indian 
Squadron, left Martinique W. I., on July 19, 1819. Two 



CANADA. 659 

days later, a sailor was stricken with yellow fever and 
died the following day. lOn July 26, four cases erupted 
among the sailors, followed the next day by six additional 
cases. In the meantime, the Tarn reached Saint-Pierre- 
de-M;iquelon with many of her crew down with the fever. 
Two died while the vessel was in the harbor, one on the 
seventh and the other on the tenth day of the attack. The 
disease then subsided without infecting the town.^ 

Bibliography of Yellow Fever in Canada. 

1. Birthwhistle : Lancet (London), 1846, vol. 1, p. 8. 

2. Slayter: Transactions Epidemiological Society of 

London (1860-66), 1863, vol. 1, p. 354. 
Ibid. Medical Circular, London, 1862, vol. 31, p. 85. 
Ibid. Lancet (London), 1862, vol. 2, p. 91. 
Milroy: Trans. Ep. Soc. London, 1862, p. 90. 
Berenger-Feraud : Gazette des Hopitaux, Paris, 

1884, vol. 57, p. 803. 

3. .'Keating: History of Yellow Fever, p. 94. 

4. National Board of Health Bulletin, 1879-80, vol. 1, 

p. 428. ' 

5. Walshe: Medical and Physical Journal, London, 

J 1806, vol. 15, 446. 

6. Ibid., p. 449 

7. Berenger-Feraud : Traite Theorique et Pratique de 

la Fievre Jaune, Paris, 1890, p. 84. 

8. Berenger-Feraud, loc. cit., p. 140. 

9. Keraudren : De la Fievre Jaune Observee aux An- 

tilles et sur les Vaisseaux du Roi, etc. (Paris, 
1823, p. 18. 



660 

CENTRAL AMERICA. 

History of Yellow Fever in Central America. 

Contrary to general ex]3ectations, Central America 
presents a sterile field for the study of yellow fever from 
a point of widespread prevalence. Although within a 
stone's throw from the West Indies, whence yellow fever 
radiated in the past to the four points of the compass, 
it has been remarkably free from the disease. Save for 
a fringe of coast-line bordering on the Atlantic, it can 
be said that the Central American States have enjoyed 
comparative freedom from invasions of the yellow scourge 
and one can, in almost every outbreak, place the onus on 
importation. What renders the situation still more 
perplexing, is that both to the north and south of the 
bellicose little republics which compose the Central 
American dis-Union, yellow fever is almost endemic, Mex- 
ico, the- Isthmus of Panama and Venezuela having been 
notorious foci of the American Pestilence since the days 
of the buccaneers. 

/How can this almost total exemption be accounted for? 
Surely not by the absence of the usual causes favorable 
to the propagation of yellow fever, for we find them all 
in Central America, even the pestiferous Stegomi/ia 
Galopus. Yet the Latin republics have had only two 
widespread epidemics in the past four hundred years. 
The yellow fever outbreak of 1878 was almost a pandemic, 
a case 'being imported even to London, England; yet there 
is no record of any invasion of the Central American 
States that year. Again, during the widespread epidemic 
of 1897, when the Mississippi Valley was invaded as far 
north as Cairo, and cases were imported to Xew York, 
Philadelphia, San Francisco, Baltimore and other local- 
ities hostile to yellow fever propagation, only a few 
isolated cases were observed in Salvador and Nicaragua, 
the balance of the States escaping infection altogether. 
In 1905, however, Honduras, Guatemala and Nicaragua 
were pretty widely infected, while Costa Rica and Sal- 
vador escaped contamination. 



CENTRAL AMERICA. 661 

CHRONOLOGY OF YELLOW FEVER IN CENTRAL 

AMERICA. 

1596. Locality not mentioned. 

No Authentic Details Available hetween 1598 and 1803. 

1803. HONDURAS. 

No details. 

1839. GENERAL. 

No details. 

1850. HONDURAS. 
No details. 

1860. HONDURAS. 

No details. ' 

1860. BRITISH HONDURAS. 
Belize. 

1868. NICARAGUA. 
No details. 
SALVADOR. 
San Salvador. 

1869: NICARAGUA. 

No details. 

1870. NICARAGUA. 

No details.' 

" SALVADOR. 

' No details. 

1883. COSTA RICA. 
San Jose. 

1887. GUATEMALA. 
Livingston. 



662 HISTORY OF YELOW FFVER. 

1890. BRITISH HONDURAS. 

Belize. 
" COSTA RICA. 
Port Limon. 

1891. COSTARICA. 

Punta Arenas. 

1892. COSTA RICA. 

Alajuela. 
Heredia. 
Livingston. 
Port Limon. 

1893. GUATEMALA. 

Livingston. 
" HONDURAS. 
Ceiba. 

1894. HONDURAS. 

No details. 
" NICARAGUA. 

General, but epidemic in : 

Granada. 

Managna. 
" SALVADOR. 

General, but epidemic in: 

La Libertad. 

San Salvador. 

1895. GUATEMALA. 

Champirico. 
" SALVADOR. 
Acajutla. 
La Libertad. 
San Salvador. 

1897. NICARAGUA. 

Corinto. 

Leon. 

Managua. 



CENTRAL AMERICA. 663 



SALVADOR. 

San Salvador. 

1898. COSTA RICA. 

Port Limon. 
" SALVADOR. 

San Salvador. 

1899. COSTA RICA. 

Alajuela. 
Heredia. 
Port Limon. 
Punta Arenas. 
" SALVADOR. 

San Salvador. 

1900. COSTA RICA. 

Alajuela. 
Port Limon. 
Punta Arenas. 
San Juan. 
San Jose. 
" SALVADOR. 

San Salvador. 

1901. COSTA RICA. 

Alajuela. 
Jaeunapa. 
Liberia. 
Port Limon. 
" SALVADOR. 
San Jose. 

1902. COSTA RICA. 

Port Limon. 

1903. COSTA RICA. 

Matina. 
Port Limon. 
San Jose. 
Zent. 



664 HISTORY OF YELLOW FKVIR. 

" NICAEAGUA. 
Bluefields. 

1904 COSTARICA. 
Alajuela. 
Port Limon. 

1905. BRITISH HONDURAS. 

Belize. 
GUATEMALxl. 

Gualan. 
Livingston. 
Tucura. 
Zacapa. 
HONDURAS. 
Ceiba. 

Chamelicon. 
Cienaguita. i 

Cholona. 
Puerto Cortez. 

NICARAGUA. 

Leon. 
Managua. 
San Francisco. 
San Pedro. 

1906. COSTA RICA. 

Port Limon. 

San Juan. 
'' HONDURAS. 

Ceiba. 

Choloma". 

El Pariso. 

Pimenta. 

Puerto Cortez. 

San Pedro. 
" GUATEMALA. 

Gualan. 
" NICARAGUA. 

Managua. 



CEMTRAL ANERICA. 66 



1907. COSTA KICA. 
San Jose. 
San Mateo. 



a 



GUATEMALA. 
Gualan. 

Puerto Barrios. 
Zacapa. 

NICAEAGUA. 
Managua. 

1908. GUATEMALA. 
Chiquimula. 
Zacapa. 



BRITISH HONDURAS. 

British Honduras (also known as Balize or Belize), a 
British Colony of Central America, borders on the Bay 
of Hunduras, an arm of the Gulf of Mexico, and lies 
between Mexico and Guatemala. Capital, Belize, on the 
Bay of Honduras, which has a population of about 6,000, 
mostly blacks. 

SUMMAEY OF EPIDEMICS. 

Belize. 

The history of yellow fever in Belize can be summed up 
in a very few words. The only white people in the town 
are English officers and traders and a few Americans. 
The balance of the population are negroes, who are pro- 
verbially immune from yellow fever and which accounts 
for the few outbreaks of the fever recorded in this history. 

1860. 

In the middle of July, 1860, yellow fever broke out in 
Belize, and in a short time decimated the white popula- 
tion, especially new-comers. The negroes and acclimated 
whites nearly all escaped, as did also the troops. The 
latter, ^dth the exception of the officers, were black. An 
army assistant sergeant died. No statistics are given by 
our authority.^ 

1890. 

Yellow fever broke out among the British colonists at 
Belize in February, 1890. The first death occurred on 
February 17. There were altogether five cases, of which 
four proved fatal. The last case erupted May 23, and 
the last death took place June 1.^ 



CENTRAL AMERICA. 667 

1905. 

From June 20, when the first case was reported, to 
November 30, 1905, there were &Ye cases of yellow fever 
in Belize, of which three proved fatal. The victims were 
Englishmen.^ 



668 

COSTA RICA. 

Description. 

Costa Kica (rich coast) the most southern republic of 
Central America, lies between the Caribbean Sea and the 
Pacific Ocean and is bounded on the north by Nicaragua 
and on the south by Panama. Capital, San Jose. Punta 
Arenas, on the Pacific and Port Limon on the Caribbean, 
are its principal ports.^ 

SUMMAEY OF EPIDEMICS. 

Alajuela. 

1892. 

Alajuela, 3,000 feet above the sea-level, was thought 
for a long time to be immune from invasions of yellow* 
fever, owing to its elevation. In 1892, however, the dis- 
ease was imported to the town. The infection was not 
widespread. The number of cases and deaths is not given 
by our authority.^ 

1899. 

In 1899, Alajuela had a population of about 10,000. 
In the middle of August, a man arrived from Punta 
Arenas, where there had been sporadic cases of yellow 
fever for some time previous to his departure. He was 
taken ill with yellow fever shortly after arriving at 
Alajuela. From August 4 to September 24, 60 cases re- 
sulted, of which 21 proved fatal.^ Another authority 
states that there were 100 deaths, but does not give the 
number of cases. ^ 

1901. 

A solitary case of yellow fever was observed in Alajuela 
on June 7, 1901. The patient died."^ 



CENTRAL AMERICA. 669 

1904. 

Yellow fever siuddenly made its appearance at Alajuela 
about the middle of April, 1904. From the 18th to the 
24th of the month, there were 11 cases, of which 6 died.^ 
The outbreak subsided as suddenly as it had begun. 

HEKEDIA. 

1892. 

Yellow fever '^prevailed" in Heredia (six miles from 
San Jose) in 1892, but to what extent, our source of in- 
formation^ does not state. 

1899. 

A solitary case was imported to Heredia from Alajuela 
in 1899. The ultimate fate of this case is left to con- 
jecture.^^ 

LIBEEIA. 

. 1901. 

Liberia, a city of about 6,000 inhabitants, located in 
the ^'hot lands" near the Pacific Coast, was invaded by 
yellow fever for the only time in its history in 1901. The 
number of cases is not stated, but 66 deaths were recorded 
between March 21 and August 15. As the white popu- 
lation of Liberia is very sparse and the natives of Central 
America are seldom attacked by yellow fever, this mor- 
tality may certainly be considered excessive.^^ 

MATINA. , 

The village of Matina, 10 miles from Limon, on the 
Matina River, had 2 cases of yellow fever in 1903. The 
infection probably came from Port Limon.^^ 



670 HISTORY OF YELLOW FKYER. 

POET LIMON. 

Port Limon is on the east coast of Costa Kica, on the 
Caribbean Sea. It has a good harbor and is the eastern 
terminus of the Costa Kica Kailway. It is surrounded 
by dense forests and does an extensive exporting trade 
in fruit, coffee, rubber, sarsaparilla and skins. Popula- 
tion, 5,000. 

Port Limon is not an endemic focus of yellow fever, 
the disease always having been imported in every recorded 
instance. Of late years, however, or, to be more precise, 
since 1900, yellow fever has been present almost every 
year in the port. In 1901, the infection was widespread, 
thirty-two foci being created within the corporate limits 
of the town, resulting in 63 cases and 17 deaths. In 1903, 
another widespread epidemic took place. As three-fourths 
of the population of Port Limon are negroes — a race com- 
monly immune from attacks of yellow fever^ — and the 
whites generally flee w^henever an outbreak of yellow fever 
assumes a malignant phase — there is certainly ground 
for alarm that the disease may become endemic. Only 
the modern measures intelligently directed against the 
inroads of the yellow plague^ — the screening of first cases 
and the total extermination of the Stegomyia Calolpus — 
can save the beautiful metropolis of Central America from 
becoming, like her South American neighbors, the en- 
demic home of a disease which modern science has proved 
can be eradicated from a community. The brilliant vic- 
tories achieved in Havana, New Orleans and Panama are 
monumental examples of what well-directed preventive 
measures can accomplish. The same thing can be done 
in Central America. 

Summary of Epidemics. 

1890. 

Although yellow fever undoubtedly prevailed at Port 
Limon in former years, no authentic record can be found 
previous to 1890. In December of that year, 2 cases were 



CENSRAL AMERICA. 67 i 

observed, but whether they proved fatal or not, is not 
stated. ^^ 

1893. 

Sporadic cases of yellow fever broke out in Port Limon 
at the end of May, 1893. An old man, an employe of the 
customhouse, a native unacclimated to Limon, died of 
the fever on the 28th. On the report of this death, there 
was a general exodus of the white residents into the in- 
terior, most of them migrating to San Jose. By means 
of this partial depopulation, only acclimated negroes re- 
maining, the progress of the outbreak was checked. ^^ 

1898. 

From June 14 to September 1, 1898, there were six 
deaths from yellow fever in Port Limon.^^ 

1899. 

From August 18 to August 29, 1899, 2 cases and 1 
death.^^ 

1900. 

The first case in 1900 was in the person of a Costa 
Kican, aged 76, who was taken ill on April 19, less than 
three days* after his arrival from the interior of the 
country, and is presumed to have been infected at Punta 
Arenas. The patient died on the 20th. 

The steamship jB"o?s^e/n arrived at Port Limon from 
Mobile, Alabama, August 16. Two days later the captain 
of the vessel died of yelloAv fever. There was no yellow 
fever at Mobile in 1900, so the vessel was evidently in- 
fested at another port of call. 

On August 21 a case of yellow fever erupted on board 
the steamship Cunard, from Colon, and was transferred 
to the quarantine station. The patient died on the 23rd. 

Between October 31 and November 4, a case of yellow 
fever developed on shore and a case was reported on board 



672 HISTORY OF YELLOW FEVjeR. 

the steamship Adler, from Bocas del Tora, Colombia. The 
patients recovered. 

Eesume for 1900 : Total cases, 5 ; total deaths, 2^^ 

1901. 

A small epidemic of yellow fever prevailed at Port 
Limon in 1901.^8 

The first case was reported on March 31, in the person 
of a Canadian who had been in Port Limon one month. 
Recovery. The second case, an. Englishman, who had 
been in the town about a year, was taken ill June 9. 
While a resident of Port Limon, the patient had been 
employed on the railroad near Alajuela, where . yellow 
fever was prevailing, and evidently contracted the disease 
there. He recovered. 

The third case, which marked the real beginning of the 
epidemic, erupted in the person of an American, of En- 
glish parentage, who had been in Port Limon only a few 
months. He Avas admitted to the Hospital of the LTnited 
Fruit Company on July 1, suffering from yellow fever. 
He recovered. A sister of the above case, who lived in 
the same house in vrhich he spent the first two days of his 
illness, was taken ill on the eighteenth day from the initial 
chill of her brother, and had a typical, though mild fever. 
She had had no further communication with the patient 
from the time of his removal to the hospital, and her 
case is one of the thousands illustrations of the truth of 
the mosquito theory of the transmission of yellow fever. 

From this focus, the fever gradually extended through- 
out the town. From July 1 to October 12, there were 
altogether 61 cases, of which IT proved fatal. Adding to 
this the cases observed on March 31 and June 9, gives a 
total of 63 cases for 1901. 

Yelloio Fever in Port Limon During the Quarantine 
Season of 1901. 

The following comprehensive summary of this remark- 
able outbreak, made by Dr. Goodman, then Assistant 



CENTRAL AMERICA. 673 

United States Marine Hospital Surgeon at Port Limon, 
will be found interesting and instructive:^'^ 

During the quarantine season of 1901 — that is, from 
April 1 to November 1, there were 63 cases of 'yellow 
fever in Port Limon, CQsta Pica, to my personal knowl- 
edge. Of these, 45 contracted the disease in Port Limon; 
and 18 came or were brought from stations on the rail- 
road, distant 2 to 30 miles. These cases occurred by 
months as follows: April, 1 case; May, none; June, 2; 
July, 5; August, 26; September, 25; October, 4. About 
September 15 the heavy and continued rains set in and 
the mortality rate from all diseases was very much les- 
sened. For instance, there were from all causes, 39 deaths 
from August 15 to September 15, and only 19 from Sep- 
tember 15 to October- 15. 

Of these 45 cases of yellow fever, originating in Port 
Limon, 20 were natives and 25 Americans and Europeans. 
The disease appeared in 22 houses or foci, a brief history 
or description of which follows : 

Focus I.— A second-class hotel, block No. 43, 1 one- 
story building, close to the ground, in a badly drained 
lot ; thence we had case No. 1, April 1, 1901, Englishman ; 
case No. 3, June 16, 1901, Englishman; case No. 30, 
August 28, 1901, American ; case No. 59, October 28, 1901, 
American ; case No. 60, October 3, 1901, American. 

Focus II. — In the extreme western end of the town, 
7 1/2 blocks, or about 750 j^ards, from Focus I, on a hill 
surrounded by slirubberj^; rain water, caught in barrels 
and in a tank, is used for drinking; it is a one-story 
dwelling house, and here we had case No 2, June 12, 
American; case No. 33, August 29, native, wife of an 
American. 

Focus IIL^-One hundred and twenty-five yards north 
of Focus II, higher up the hill; dense foliage close to 
the house; rain water used and mosquitoes plentiful; 
communication between Foci II and III by no means 
easy, owing to undergrowth and the steep hillside; here 
we had case No. 4, July 4, American ; case No. 5, July 18, 
American; case No. 9, August 1, American. 



674 HISTORY OF YILLOW FEVER. 

Focus IV. — Two hundred and sixty yards south of 
Focus I, a two-story house on the railroad in a low, badly 
drained spot, mosquitoes plentiful; here we had case Xo. 
6, August 1, native; case Xo. 11, August 5, native; case 
Xo. 10, August 15, native; case Xo. 35, September 1, 
native. 

Focus v. — In the middle of block 17, 60 yards west of 
the park, 120 yards XE. of Focus IT, and 250 yards 
south of Focus I, one of several rooms in a long row, 
partitions going up only partly to the top. Case Xo. 12, 
August 8, native. Xo attempt at disinfection was made 
at this house, it being impossible from its construction. 
The roo mwas thrown open and strong winds and bright 
sunlight allowed to pass through. 

Focus YF — City jail, between seawall and park, 160 
yards SE. of Focus V, 220 yards S. of E. of Focus IV. 
The rst floor used for prisoners, the second is sleeping 
rooms for the policemen. Case Xo. 13, August 9, native; 
case Xo. 17, Sej)tember 20, native. 

Focus TIF — One hundred yards southeast of Focus I, 
and in the same block; offices on the ground floor, sleep- 
ing rooms above. Case Xo. 7, August 8, American ; case 
Xo. 2Sy August 23, American. 

Focus Till. — The United Fruit Company's Hospital, 
to which most of the yellow fever patients were carried 
and put into wards isolated and provided with screened 
doors and windows ; only 1 case originated here, that of 
a white nurse; all other nurses were negroes. Case Xo. 
51, August 7, Englishman. 

Focus IX. — In block 35, 15 yards south of Focus III; 
a two-story house on the hill, surrounded by shrubbery; 
cistern water used ; the hotise had been vacant for months 
until occupied by tjiis patient a few days prior to her 
illness. Case Xo. 18, Atigtist 10, Englishman. 

Focus X.— Southeast half of the Grand Hotel, a three- 
story building, one room deep, 300 feet long; attached 
to this southeast end is the hospital of the Costa Kica 
Railroad. All cases ccctirring in this btiilding, whether 
from Foci X, XVIII or XX, were in the second-story. 



CENTRAL AMERICA. 675 

where mosquitoes were troublesome at times. On the 
third floor the very strong zreezes kept the rooms free of 
them. Case No. 20, August 16, Englishman ; case No. 22, 
August IT, Englishman; case No. 44, September 12, 
American; case No. 62, October 4, American. 

Focus XI. — Custom-house; second floor used as resi- 
dence; 80 yards east of Focus VI. Case No. 21, August 
16, native; case No. 58, September 28, native. 

Foci XII and XII I. — Thirty yards south of Focus I 
and about 60 yards west of Focus VII, all in the same 
block ; Focus XII downstairs and to the rear. Focus XIII 
upstairs and to the front. Case No. 26, August 20, natice ; 
case No. 27, August 20, native. 

Focus XIY. — Twenty-flve yards north of Focus V. 
Case No. 29, August 24, native. 

Focus XY. — Twenty yards south of Focus VIII. Case 
No. 37, September 3, native. 

Focus XVI. — Forty yards northeast of Focus XIV. 
Case No. 31, August 31, native; case No. 34, September 2, 
native. 

Focus XF//.— Sixty yards E. of Focus XVI, 120 yards 
NW. of Focus X. Case No. 38, September 9, native; case 
No. 39, September 9, native. 

Focus ZF//J.— Twenty yards SE. of Focus X. Case 
No. 7, August 1, native ; case No. 40, September 6, English- 
man. 

Focus XIX. — One hundred and twenty yards N. of 
Focus IX. Case No. 42, September 9, American; case 
No. 43, September 11, American. 

Focus XX. — Northwest half of Grand Hotel, this with 
Foci X and XVIII may properly be considered as one 
building. Case No. 53, September 27, American; case 
No. 61, October 4, American. 

Focus XXI. — One hundred and twenty yards N. of 
Focus XIX and 100 yards W. of Foci I and^ XII. Case 
54, September 24, native. 

Focus XXII. — Ore hundred and twenty yards N. of 
Focus VIII. Case No. 57, September 30, German. 

In drawing deductions from the above factgi the follow- 
ing should be borne in mind: 



676 HISTORY OF YELLOW FEVER. 

Strong western and southwestern land breezes prevail 
at night, and eastern or sea breezes during the day — 
much personal intercommunication between the natives is 
probable, but between them and Americans it is at most 
very limited. 

With few exceptions the patients w^ere removed on the 
first or second da^^ of illness to the isolated yellow fever 
wards of the hospital, and disinfection of the vacated 
rooms done. 

The i)opulation of Port Limon is about 4,000, made up 
of, say, 3,000 Jamaican negroes, who seemed to be im- 
mune, and 1,000 Americans,' Europeans and natives of 
Spanish ancestry. Many of the inhabitants who could 
give no cause for immunity escaped the disease. 

Those physicians having the largest practice and the 
quarantine officials provisionlly, at least, accepted the 
mosquitoes as a means of propagation of yellow fever 
and advised the general use of mosquito netting. 

1902. 

The year 1902 witnessed another stubborn outbreak of 
yellow fever at Port Limon. 

According to Acting Assistant Surgeon Carson,-^ cases 
began showing themselves as early as March, but were 
not reported as such. The first case to receive official 
recognition was that of a native laborer, aged about 25, 
who had been sick two days without medical attention, 
and who was admitted to the United Fruit Company's 
hospital on April 14, where the nature of his illness was 
at once recognized as yellow fever. Death on the 16th. 

Between April 16 and 23, three more cases were ad- 
mitted into the hospital. All recovered. 

Week ending May 1: One case, brought from Cairo 
Junction, about 40 miles by rail from Port Limon; not 
recognized as yellow fever until after admission into the 
hospital. 

July 5, one death, an imported case from the Zent Dis- 
trict, 20 miles from Limon, on the Costa Rica Railroad. 



CENTRAL AMERICA. 677 

I 

July 10, two cases were admitted into the United Fruit 
Company's hospital, brought, respectively, from Zent 
Junction and Guasimo, 20 and 51 miles by rail from Port 
Limon. 

July 17, two new cases. 

July 22, one death at hospital. 

AiUgust 8, one death at hospital. Imported from Cairo 
Junction. 

August 22, one case, from Zent Junction, admitted to 
hospital. 

September 7, two cases, originating at Port Limon. 

Three new cases were admitted to the hospital on Octo- 
ber 6 and 7, one Italian and two Costa Kicans. 

October 6 to 30, 4 cases and 3 deaths. 

Cases broke out sporadically as late as December, the 
last case being reported on the 6th. Altogether, from 
July 4 to December 6, there were 27 cases, of which 14 
died. 

1903. 

In 1903, yellow fever broke out in April. Among the 
first to be attacked was Dr. Allan Jumel, of New Orleans, 
then Inspector of the Louisiana State Board of Health at 
Port Limon, who made an uneventful recovery. The first 
death occurred on April 17, in the person of an employe 
of the Costa Eican Railroad. From that date, the fever 
gained rapid headway, the type Jbecoming graver and less 
amenable to preventive treatment. The epidemic came 
to an end on October 29, with the following record: 
Cases, 99; deaths, 50. 



21 



1904. 

As early as March, a case of yellow fever was treated 
at the United Fruit Company's hospital. Nothing unto- 
ward happened until the end of May, when three cases 
were reported on the 28th. One was imported from a 
banana farm near Port Limon; the others originated in 
town. All recovered. 



678 HISTORY OF YELLOW FETER. 

No cases reported until July 9, when an American mis- 
sionry, who had lived for some months in Port Limon, 
was attacked. Eecovery. 

For week ending July 16, one case, a Spanish- Aonerican 
woman, a resident of Port Limon who had been two 
months in Port Limon. 

Week ending October 15, one case, imported from 
Sequires, 36 miles from Limon. Eecovery. 

Total for 1904: Cases, 7; deaths, 1.^2 

1905. 

An American, who had been for a few months resident 
in and about Port Limon, with a positive history of hav- 
ing been in the town since the morning of June 16, was 
found in a public park very sick on the 19th, and taken 
to the hospital. Sporadic cases were observed from that 
date until October 12, a total of 6 cases, of which 2 
proved fatal, being recorded.^^ 

PUNT A AKENAS. 

Only vague information can be had concerning the 
history of yellow fever in Punta Arenas. The disease was 
present in the town in 1892, 1899 and 1900, but to what 
extent is not stated.^^ 

SAN JOSE. 

1883. 

During the widespread epidemic of yellow fever in 
Mexico and Central America in 1883, a few cases were 
observed at San Jose.^^ 

1900. 

In the early days of August, 1900, a Costa Rican came 
to San Jose from Port Limon, where yellow fever was 



CENTRAL AMERICA. 679 

prevailing. He was taken ill on the 6tli and died on the 
9th, with black vomit.^® This was the only ease in San 
Jose in 1900. 

1901. 

In August, 1901, a few cases of yellow fever were im- 
ported to San Jose from Port Limon. The infection did 
not spread.^"^ 

1903. 

Three years later, another case was imported to San 
Jose from Port Limon. Dr. Bentel, a chemist in the em^ 
ploy of the Costa Rican government came to Port Limon 
from the capital, on official business in 1903. On May 27, 
he was taken ill and returned to San Jose, where he died 
on the 30th. Another case was brought to the town in 
August 3, and died two days later. There was no dif- 
fusion of the malady.-^ 

1906. 

Two cases of yellow fever were imported to San Jose 
in 1906.29 

1907. 

A physician contracted yellow fever in the banana dis- 
trict, about 45 miles from Port Limon, in September, 
1907, and went to San Jose for treatment. The report 
does not state what ultimately became of the case.^^ 

SAN JUAN. 

1900. 

A case of yellow fever was imported to San Juan in 
May, 1900. The patient recovered.^^ 



6S0 HISTORY OF YELLOW FEVER. 

ZEXT. 

1903. 

There were 4 deaths from Yellow fever at Zent Junction 
in 1903.* There must have been a widespread infection in 
the village, as several cases were imported therefrom to 
Port Limon and the surrounding country. 



681 

GUATEMALA. 

Guatemala lies south of Mexico and borders on the 
Pacific, and has a small coast line on the Bay of Hon- 
ruras. Capital, Guatemala. Puerto Barrios on the Bay 
of Honduras, is the principal port. 

The history of yellow fever in Guatemala can be told 
in a very few words. The following summary is made 
from the records of the United States Marine Hospital 
Service : 

CHAMPEEICO. 

1895. 
Yellow fever reported ''present.'- ^^ Xo details available. 
CHIQUIMULA. 

1907. 
A few cases of yellow fever reported. ^^ 

1908. 

Population, 6,000. A few cases of yellow fever, im- 
ported from Zacapa.^^ 

GUALAN. 

1905. 

A severe epidemic of yellow fever ravaged Gualan, 80 
miles from Puerto Barrios, in 1905. The number of cases 
is not given, but the stimated number of deaths, from 
August 20 to November 9,. is placed at 200. No exact 
statisitics could be obtained.^^ 

The first cases of yellow fever, in the history of the town, 
came under observation in August, 1905. The cases in the 
railroad hospital were kept under bars, and every pre- 



682 HISTORY OF YELLOW FEVER. 

caution used to prevent the spread of the infection, no 
standing water being allowed around the buildings; but 
in the town itself nothing was done. 

1906. 

August 24, two cases; one died. Sporadic cases ob- 
served during the year^' 

1907. 

Between May 15 and 21, three cases ; one died.^^ 

LIVINGSTON. 

18S7. 
August 7, four cases ; August 27, "several case^."^'-^ 

1889. 
July 28, one case, followed by death. No developments.^" 

1892. 

Yellow fever broke out in May and "raged most malig- 
nantly." No statistics given.^^ 

1905. 

Yellow fever was epidemic in many cities of Guatemala 
in 1905. A total of 27 cases, of which 12 died, is re- 
corded for Livingston..^^ 

PUEETO BAKKIOS. 

1907. 

Diligent research has failed to find any Jiistory of yel- 
low fever so far as Puerto Barrios is concerned, previous 



CENTRAL AMERICA. 683 

to 1907. On June 27, a solitary case was reported, in the 
person of a Spanish officer in charge of the curatel. Orig- 
inal source of infection not stated.^^ 

TUCAEA. 

1905. 

Tucara suffered from yellow fever during the epidemic 
of 1905. The first case was reported AugTist 7. Statistics 
are not given.^^ 

ZUGAPA. 

1905. 

The Guatemalan yellow fever epidemic of 1905 was 
quite extensive in Zucapa, a town of about 6,000 inhabi- 
tants, in the interior, 100 miles by rail from Puerto 
Barrios. 

The disease made its appearance in Zacapa the latter 
part of June. The infection was introduced from Liv- 
ingston through natives who were permitted to return 
to their homes in Zacapa after the outbreak of the fever 
in Livingston. The fever was not recognized as yellow 
fever until August, by which time the infection was thor- 
oughly disseminated throughout the town, there being 
hardly a house in the place which had not had a case. 
No reliable information as to the number of cases or 
deaths could be obtained, but reliable reports estimate the 
number of deaths at about 700.^^ At the time of the out- 
break a great number of people left and went to the 
mountains, leaving only about 3,500 in the place during 
the height of the fever. This is the first time yellow fever 
has ever appeared in Zacapa. 

1907. 

The second appearance of yellow fever in Zacapa took 
place in 1907. On May 16, a case was imported from 
Gualan. In the latter part of May, the disease was re- 



684 HISTORY OF YELLOW FEVER. 

ported epidemic, with about two deaths daily. No reli- 
able statistics could be obtained. Sporadic cases were 
observed as late as Xovember:^^ 



685 

HONDURAS. 

Honduras, one of the Central American Eepublics, lies 
between . Nicaragua and San Salvador and the Pacific 
Ocean and the Caribbean Sea. Capital, Tegucigalpa. 

Although discovered bv Columbus on his fourth voy- 
age (1502), and in close proximity to the West Indies, 
it is only within very recent years that yellow fever has 
been observed in Honduras. Berenger-Feraud^'' speaks 
of a ''severe epidemic" in that country in 1803, imported 
by the ship Hihhe}% but gives no details. The same 
authority (page 119) says that Honduras was ''contami- 
nated'' in 1850, but in what manner and to what extent, 
is left to the imagination. With the exception of 1905, 
no general epidemic of yellow fever has ever been observed 
in Honduras. 

CEIBA. 

1905. 

From August 1 to 21, 1905, there were six cases of 
3^ellow fever in Cpiba, of which three proved fatal. One 
of the cases was imported by the steamship yicaragie, 
from Xew Orleans. Last death, August 22. The out- 
break was not very extensive. "^^ 

1906. 

Yellow fever Avas reported "present'' in Ceiba from July 
21 to 29 ; no details given.^^ 

CHAMELICON. 

1905. 

From June 18 to October 10, 1905, there were 143 cases 
of yellow fever in Chamelicon ; 49 died.^^ 



686 HISTORY OF YELLOW FEVER. 

CHOLONA. 
1905; 1906. 

Cholona, which has a population of about 4,000, has 
been visited twice by yellow fever — 1905 and 1906. 

In 1905, from June 18 to December 12, 150 cases were 
observed; 59 died.^^ 

In 1906, from April 6 to April 19, there were 7 cases ; 
1 died.52 

CIE:^rAGUITA. 

1905. 

]\Iarch 21 to September 7, 20 cases; 5 deaths.^^ 

EL PAEISO. 

1906. 

Present between June 15 and June 19. No record of 
cases; 1 death.^^ 

• NACAOME. 

1891. 

April 8 to 28, 5 deaths ; number of cases not reported.^^ 

PIMENTA. 

1906. 

May 23, 20 cases reported, which proves that the town 
must have been infected for some time previously. From' 
that date to June 6, a total of 85 cases and 20 deaths is 
recorded. The epidemic lasted until October, but com- 
plete statistics are not obtainable.^^ 



CENTRAL AMERICA. 68? 

PUEETO CORTEZ. 
1905. 

Imported cases of yellow fever may have been observed 
at Puerto Cortez previous to 1905, but no authentic 
records could be found bearing on the subject. 

The only epidemic which has ever visited the port, took 
place in 1905, and is thus described in the United States 
Public Health Eeports:^^ 

The first case to come under observation was reported 
May 25. The patient a young man was taken sick sud- 
denly with a chill in the night, violent pains in the back 
and head, vomiting and delirium. On the third day urinal 
examination showed 15 per cent, albumen. He died on 
the eighth day, in convulsions. This was a typical case 
throughout. 

The next case was an old man at a hotel. He had all 
the symptoms. Was taken ill suddenly ; on the third day 
albumen showing as much as 4 per cent. He died on the 
sixth day in coma. 

The next patient was a custom-house inspector, who 
was taken ill with the same symptoms and about the same 
time as the second case. On the fifth day albumen showed 
25 per cent.; temperature, 102; pulse, 46; died in coma. 

Another case was that of a native boy, reported by the 
Government surgeon at about the same time. He also 
died. All had black vomit, except the old man at the 
hotel. Four other cases were taken sick about the same 
time and recovered. The first, a woman boarding at the 
hotel, was taken violently ill with a chill in the night, 
with vomiting, violent pains in the back, limbs, head and 
delirium. On the third day albumen from 10 to 15 per 
cent. This case recovered. The daughter of this patient 
was attacked in the same way, with the same train of 
symptoms, during her mother's convelescence. Aubumen 
about 10 per cent. ; urine cleared up on the 6th day ; went 
on to recovery. 

An Italian at the hotel was attacked about the same 



688 HISTORY OF YELLOW FEVER. 

time. His was a typical case. Albumen, 25 per cent.; 
pulse went as low as 40, with a slow convalescence. 

The eighth case was that of the surgeon of the United 
Fruit Company and is of much interest, showing the 
enormous quantity of sulphate of quinine a person of long 
experience in the Tropics can stand without injury in yel- 
low fever. This patient had lived in the Tropics about 
fifteen years, having spent Axe years of his life at Limon, 
going through three epidemics there without contracting 
the disease. He considered himself immune. On May 
30 he was taken violently ill with all the train of symp- 
toms of yellow fever. Two days before this he complained 
of feeling very badly, but still remained at work, and 
said he supposed he was going to have a sharp spell of 
remittent fever, as he had not had an attack for a long 
time. He began taking large does of sulphate of quinine 
to reduce the temperature, but he complained he could 
not. bring his temperature to normal and lower than 
101 1/2, and during the two days before he was taken 
ill, he told me that he took 280 grains of sulphate of 
quinine and 1 ounce of Warburg's tincture to reduce his 
temperature. On Thursday night he had the preliminary 
chill, temperature going to 104 1/2, and from that time- 
on during his illness he never showed the bad effects of 
the quinine, although he had a very serious attack of 
yellow fever and at one time the urine test showed 25 per 
cent, albumen. 

Of the first eight cases of the epiclemic, four recovered 
and four died. 

From the date of the breaking out of the epidemic (May 
25) to June 18, 10 additonal cases were reported, of which 
4 diedi 

The epidemic came to an end on December 12^ with a 
record of 148 cases, of which 50 died. 

1906. 

On March 7, 1906, a case of yellow fever was reported 
in Puerto Cortez. It was a mild case and the patient 



CENTRAL AMERICA. 689 

made an uneventful recovery. No other cases are re- 
corded.^^ 

SAN PEDEO. 

1905. 

San Pedro, 35 miles from Puerto Cortez, experienced 
its first extensive epidemic of yellow fever in 1905. From 
June 18 to December 12, there were 625 cases, of which 
153 proved fatal.^^ 

1906. 

March 18 to March 24. Yellow fever present. No 
statistics.^^ 



690 

NICARAGUA. 

• Description. 

Nicaragua lies between Honduras and Costa Eica and 
extends from the Caribbean Sea to the Pacifis Ocean. 
Principal cities: Bluefields, Leon, Granada, Nicaragua 
and Managua, the capital. 

Berenger-Feraud sajs that yellow fever was imported 
to Nicaragua in 1868 by voyagers froni infected localities, 
but gives no details, merely mentioning this fact and stat- 
ing that ''several localities" were affected.^^ 

According to Lawson, the disease was also present in 
Nicaragua in 1869.^- 

Cornilliac notes the fact that manv localities were af- 
fected in 1870.63 

BLUEFIELDS. 

1903. 

Bluefields is on the Caribbean coast of Nicaragua, and 
has a population of about 3,000. Yellow fever has 
rarely been observed at this port, and in every instance it 
was imported. Statistics are meager and unreliable con- 
cerning the prevalence of the disease at Bluefields, the 
only authentic case on record being in 1903, when the 
Schooner Sunbeam, from Limon, brought a case to the 
town on May 8. Proper sanitary measures were insti- 
tuted and there was no spread.^^ 

COKINTO. 

1897. 

Corinto, like other ports on the Pacific coast of Nica- 
ragua, has been almost immune from yellow fever. The 
only instance when the disease made any headway in this 
port was in 1897, when it was introduced by vessels com- 



CENTRAL AMERICA. 691 

ing from infected Mexican and South American ports. 
Eeliable statistics as to the extent of this outbreak are 
lacking.^^ 

GEANADA. 

1894. 

Granada has a population of 15,000 and is on the north- 
west shore of Lake Nicaragua, about 30 miles from the 
city of Nicaragua. Yellow fever prevailed to a limited 
extent in this place in 1894. No statistics obtainable.^^ 

JUCUNAPA. 

1901. 

« 

A case of yellow fever was brought to Jucunapa in 
1901. As soon as the inhabitants became aware of the 
state of affairs, they fled to various parts of the republic, 
leaving the town practically deserted. Only one case is 
recorded.^"^ 

LEON. 

1897. 

Leon lies between Lake Managua and the Pacific Ocean 
and has a population of 25,000. Yellow fever was brought 
to Leon by refugees in August, 1897, and prevailed epi- 
demically to the end of September, according to official 
reports. No statistics could be obtained. ^^ 

1905. 

^1 

Yellow fever prevailed for the second time in the his- 
tory of Leon in 1905. Like other. epidemics of this kind 
in Central America, details are lacking.^^ 



692 HISTORY OF YKLLOW FEVER. 

ma:n^agua. 

The history of yellow fever as it concerns Managua 
may be briefly summarized as follows, as no details are 
obtainable 'J^ 

1894. Present. 

1897. Present. 

1905. Thirty cases; number of deaths not stated. 

1906. Present. 

1907. Present. 

SAN FEANCISCO. 

1905. 

The extensive yellow fever epidemic- of 1905 invaded San 
Francisco, a small town near the Pacific coast, during the 
last days of August. The number of cases is not given; 
deaths, 2.'^ 



69S 

SALVADOR. 

Salvador is bounded on the north by Honduras and 
Guatemala, east by Nicaragua and south by the Pacific 
Ocean. Capital, San Salvador. 

Salvador has suffered less from yellow fever than the 
other countries of Central America. The outbreaks so far 
as could be collected from the scant literature on the sub- 
ject, were as follows: 

ACAJITLA. 

1896. Yellow fever reported as prevailing extensively. 
No statistics.'^^ 

LA LIBEETAD. 

1894. Yellow fever '^present."'^ 

1896. Yellow fever reported as "making rapid pro- 
gress." No statistics.^'* 

SAN SALVADOE. 

The city of San Salvador is one of the oldest in Central 
America, having been founded by the Spanish in 1523. It 
is 105 miles southeast from Guatemala, near the Pacific 
Ocean. San Salvador was moved from its original site 
near the base of the volcano of the same name in 1854, 
on account of the prevalence of destructive earthquakes, 
but it has since twice been partially destroyed by these 
mysterious convulsions of nature. Before the last earth- 
quake (1873) the population was 40,000; it is now about 
half that figure. 

1868. 

The first record of yellow fever having prevailed in 
San Salvador is given by Guzman, who states that 401 
cases were treated at the Casa Amarilla (yellow fever 
hospital) in 1868. Of these cases, 296 were males and 
85 females. The mortality was 132 (85 males and 47 
females. The source of infection is not sriven.'^^ 



694 HISTORY OF "i'ELLOW FEVER. 

1870. 

Cornilliac states that Yellow fever was obserred in San 
Salvador in 1870. Xo sTatistics."^ 

1894. 

After a lapse of 21 years, yellow fever again made its 
appearance in San Salvador. The first person attacked 
was one of the mail-service boys, who caught the infec- 
tion at La Libertad. Beyond the statement that the mor- 
tality was 60 per cent., no other information is given by 
our anthoritv."" 

1896. 

Yellow fever was reported "present" in San Salvador 
in October 19. 1906. Further details not obtainable.'^ 

1897. 

Yellow fever broke out with much virulence in -Inly 
and raged tintil December. Cases and deaths were as 
follows : 

July 38 cases. 11 deaths. 

Augtist 51 cases. 16 deaths. 

September 31 cases. 12 deaths. 



Total for three months . . 126 39 

The epidemic decimated the foreign population. 
Among the prominent victims were the Kussian Princess 
Dolgorouky, who had come to San Salvador to give con- 
certs, and Mr. Baker, the manager of the London Bank. 
The American Colony did not stiffer much. 

The epidemic came to an end in December. Complete 
statistics not siven."^' 

1898. 

Yellow fever again broke out in San Salvador in 1898. 
Following statistics are ftirnished by the United States 
Marine Hospital Service.^'^^ 



CENTRAL AMERICA. 695 

To June 4, total of 34 cases and 8 deaths. 
From that date to August.?, 38 new cases, of which 
8 proved fatal. 

Total, 72 cases ; 16 deaths. 

1899. 

June 30 to August 1, a total of 3 cases and 1 death is 
reported. ^-"^ 

1900. 

Yellow fever broke out as early as February ; five 
deaths being reported between the 11th of that month 
and March 3. Between the last mentioned date and 
April 11, there were 38 ncAv cases. After this, the epi- 
demic subsided, only 3 new cases and 1 death being re- 
ported to August 1. Sporadic cases were subsequently 
observed, but no complete statistics are obtainable.^^ 

1901. 

In 1901 the fever broke out during the last week of 
March, and from that time to the end of June, 10 cases 
and 6 deaths were reported. As in other outbreaks of the 
disease, it is impossible to give exact statistics. In every 
eruption of yellow fever in Central America, the policy 
of concealment is adhered to by the authorities, and it is 
only by constant vigilance that the representatives of 
foreign governments are able to arrive at the truth. ^^ 

That yellow fever prevailed to a considerable extent in 
San Salvador in 1901, is evidenced by the fact that a, 
certain college in that city was ordered closed by the 
government; five cases and one death having occurred 
among the students. 

1907. 

Yellow fever was reported epidemic in the Kepublic 
of Salvador in January, 1907.^! No further information 
is furnished, but the outbreak could not have been very 



696 HISTORY OF YELLOW FEVER. 

severe, for even the most guarded policy of concealment 
could not have kept the facts from the public during the 
two Tears which have elapsed since the first news were 
telegraphed to the United States Marine Hospital Service 
at Washington. 

SANTIAGO DE MAEIA. 

1901. 
Eefugees from Jucunapa infected Santiago de Maria in 
1901, for the first time in its history. Xo statistics.^^ 

BIBLIOGRAPHY OF YELLOW FEVER IN CENTRAL AMERICA. 

GENERAL. 

Brumby (W. M.) Our Commercial Relations -witli Central America, 
witli reference to Yellow Fever. Texas State Journal of Medicine, 
1906, vol. 2, p. 86. 

Gibbs (B. F.) : The calenturia, congestive fever of Nicaragua, in its 
relations to yellow fever. Med. & Surg. Reporter, Phila., 1868, vol. 
19, pp. 391, 413. 

Santos Fernandez (J.) : La Fiebre Amarilla es el obstaculo mas 
grande que encuentra la civilization de le America Latina.. Cron. Med. 
Quir. de la Habana, 1896, vol. 22, p. 347. 

BRITISH HONDURAS. 

1. Lawson: Transactions Epidemiological Society of London, 1860, 
vol 1, p. 138. 

2. Goldwaite: Correspondence Relative to the Insanitary Conditions 
at Belize in 1890. Colonial Office, London, 1891, p. 16. • 

3. U. S. Public Healtb Reports (Washington, D. C), 1905, vol. 20, 
p. 2770. 

Boyce, (R.) : Report to the Government of British Honduras upon 
the Outbreak of Yellow Fever in that colony in 1905. 1906. 

Ross (R.) and Breinl (A.) : Yellow Fever in Belize, British Medical 
Journal, vol. 2, for 1906, p.. 1604. 

Eyles (C. H.) : Yellow fever in Belize. Br.it. M. J. (London), 1907, 
vol. 1, p. 113. 

COSTA RICA. 

4. U. S. Public Health Reports, 1892, vol. 7, p. 120. 

5. Ibid, 1899, vol. 14, pp. 1389; 2366. 



CENTRAL AMERICA. 697 

■6. Recueil des Travaux du Comite Consiiltatif d'Hygiene Publique 
de France, Paris, 1903, p. 334. 

7. U. S. Public Health Reports, vol. 16, pp. 1415, 1594. 

8. Ibid., 1904, vol.. 19, pp. 858, 1304. 

9. Ibid., 1892, vol. 7, p. 129. 

10. Ibid., 1899, vol. 14, pp. 1389, 2366. 

11. Recueil des Travaux, etc., (loc. cit.) for 1901, Paris, 1903, p. 334. 
Also: U. S. Public Health Reports, 1903, vol. 18, p. 2309. 

12. U. S. Public Health Reports, 1903, vol. 18, p. 2309. ^ 

13. Ibid,, 1891, vol. 6, p. 138 (foot-note d.) 

14. Ibid., 1893, vol. 8, pp. 441, 452, 453, 517. 

15. Ibid., 1898, vol. 13, p. 157.' 

16. Ibid., 1899, vol. 14, p. 2366. 

17,. Ibid., 1900, vol. 15, pp. 1072, 2089, 2164, 2227, 2826, 3176. 

18. Ibid., 1901, vol. 16, pp. 772, 847, 906, 1416, 1481, 1641, 1878, 1949, 
2003, 2059, 2121, 2225, 2383, 3083. 

19. Goodman: U. S. Public Health Reports, 1902, vol. 17, p. 135. 

20. U. S. Public Health Reports, 1902, vol. 17, pp. 953, 1079, 1143, 
1745, 1796, 1842, 2067, 2112, 2230, 2468, 2622.. 

21. ilbid., 1903, vol. 18, pp. 1037, 2309. 

22. Ibid., 1904, vol. 19, p.p. 858, 1232, 1571, 1428, 1578, 2690, 

23. Ibid., 1906, vol. 21, pp. 758, 782, 1132, 1542. 

24. Ibid., 1892, vol.. 7, p. 139; 1899, vol. 14, pp. 1389 and 2366; 1900, 
vol. 15, p. 938. 

25. Medical News, N. Y., 1883, vol. 43, p. 419. 

26. U. S. Public Health Reports, 1901, vol. 16, p. 1948. 

27.. Recueil des Travaux du Comite Consultatif d'Hygiene Publique 
de France, etc., 1901 (Paris, 1903), p. 334. 

28. U. S. Public Health Reports, 1903, vol. 18, pp. 975, 2309. 

29. Ibid-., 1907, vol. 22, p. 904. 

30. Ibid., 1907, vol.. 22, p. 1444. 

31. Ibid., 1900, vol. 15, p. 1617. 

32. Ibid., 1903, vol. 18, p. 2309. 

Gruver: Case of yellow fever on steamship Westgate. U. S. Public 
Health Reports, Wash., 1903, vol. 18, p. 1310. 

Merry (W. L.) : Yellow Fever at Alajuela, 3,000 ft. above Sea Level, 
and Heredia. Pub. Health Reports U. S. Mar. Hosp. Serv., Wash., 
1899, vol. 14, p. 1389. 

GAUTEMALA. 

33. U. S. Public Health Reports, 1895, vol. 10, p. 612. 

34. Ibid., 1908, vol. 23, p. 45. 

35. Ibid., 1908, pp. 45, 157, 534. 



698 HISTORY OF YELLOW FEVER. 

36. Ibid., 1905, vol. 20, p. 2770. 

37. Ibid,, 1906, vol. 21, p. 1075. 

38. Ibid., 1907, vol. 22, pp. 765, 807, 904. 

39. Ibid., 1887, vol. 2, pp. 145, 162. 

40. Ibid., 1889, vol. 4, p. 240,. 

41. Ibid., 1892, vol. 7, pp. 243, 283. 

42. Ibid., 1905, vol. 20, p. 2631. 

43. Ibid,, 1907, vol. 22, pp. 92^, 972, 1939. 

44. Ibid., 1905, vol. 20, pp. 2035, 2770. 

45. Ibid., 1905, vol. 20, p. 2631. 

46. Ibid., 1907, vol. 22, p. 807; Ibid., 1008, vol. 23, p. 45. . 

HONDURAS. 

47. Berenger-Feraud: Traite Theorique e't Pratique de la Fievre 
Jaune (Paris, 1890), p. 73. 

48. U. S. Public Health Reports, 1905, vol. 20, p. 1911. 

49. Ibid., 1906, vol. 21, p. 1553. 

50. Ibid., 1905, vol. 20, p. 2770. 

51. Ibid., 1905, vol. 20, p. 2770. 

52. Ibid., 1906, vol. 21, pp.. 392, 452, 741. 

53. Ibid., 1905, vol. 2.0, p. 2770. 

54. Ibid., 1906, vol. 21, p. 741. 

55. Ann. Rep. Sup. Surg.-Gen. (U. S.), 1894, p. 293. 

56. U. S. Public Health Reports, 1906, vol. 21, pp. 659, 692, 762, 763, 
874, 1553. 

57. Ibid., 1905, vol. 20, pp. 1350, 2169, 2770. 

58. Ibid., 1906, vol. 21, pp. 302, 741, 989. 

59. Ibid., 1905, vqI. 20, pp. 1536, 1912, 2770. 

60. Ibid., 1906, vol. 21, p. 741. 

Carter: History of outbreak of yellow fever at Puerto Cortez. Pub. 
Health Rep. U. S. Mar. Hosp. Serv., Wash., 1905, vol. 20, p. 1350. 

NICARAGUA. 

61. Berenger-Feraud, loc. cit., p. 144. 

62. Lawson: Trans. Epidemiological Society of London, vol. 3, p. 
321. 

63. Cornilliac: Recherches Chronologiques, etc., p. 428, 

64. U. S. Public Health Reports, 1903, vol. 18, p. 1037. 

65. Ibid., 1897, vol. 12, pp. 1124, 1434. 

66. Annual Report Superv. Surg.-G-en. (U. S.), 1894, p. 293. 

67. U. S. Public Health Reports, 1901, vol. 16, p. 1724. 

68. Ibid., 1897, vol. 12, p. 1434. 



CENTRAL AMERICA. fi99 

69. Ibid., 1905, vol. 20, p. 2770. 

70. Annual Report Sup. Surg.-Gen., 1894, p. 293; U. S. Public Health 
Reports, 1897, p. 1434; Ibid., 1905, p. 2770; Ibid., 1906, pp. 742, 1553; 
Ibid., 1907, p. 1938. 

71. Ibid., 1905, vol. 20, p. 2770. 

72. Ibid., 1896, vol. 11, p. 1062. 

73. Ann. Rep. Sup. Surgeon-General, 1894, p. 293,. 

• 74. U. S. Public Health Reports, 1896, vol. 11, p. 1062. 

75. Guzman: Theses de Paris, 1869, No. 229, pp. 85-102. 

76. Cornilliac: Recherches Chronologiques., etc., p. 428. 

77. Annual* Report Supervising Surgeon-General (U. S.), 1894, p. 
293. Also: U. S. Public Health Reports, 1897, vol. 12, p. 1183. 

78. U. S. Public Health Reports, 1896, vol. 11, p.. 1062; also, 1897, p. 
1183. 

79. Ibid., 1897, vol. 12, pp. 1183, 1358, 1434. 

80. Ibid., 1898, vol. 13, p. 1572. 

81. Ibid., 1899, vol. 14, p. 2367. 

82. Ibid., 1900, vol. 15, pp. 1682, 2387. 

83. Ibid., 1901, vol. 16, pp. 1504, 1724, 3084. 

84. Ibid., 1907, vol. 22, pp. 62, 1057. 

85. Ibid., 1901, vol. 16, p. 1724. 



700 

MEXICO. 

History of Yellow Fever in Mexco. 

Mexico presents an interesting and prolific field for the 
study of yellow fever. 

Yellow fever {the vomit o prieto) of the early Spanish 
colonists, has prevailed from time immemorial between 
the mouth of the Eio Antigua and the present port of 
Vera Cruz. The Abbe Chavigero, whose History of 
Mexico is a classic, aifirms that the disease under dis- 
cussion appeared for the first time in Mexico in 1725. It 
is a matter of history, however, that long before the 
arrival of Cortez and his murderous band of pillagers, 
there prevailed periodically in ^'Xew Spain'' an epidem- 
ical disease called by the natives MatlazaliuatJ, which was 
no doubt the same as the yellow fever of the present day. 

Endemic Foci of Yellow Fever in Mexico. 

In a paf>er read before the American Public Health 
Association, at its Annual Convention in 1893, Dr. 
Eduardo Liceaga, of Mexico, gives a minute and elaborate 
history of the ravages of yellow fever in Mexico. The 
learned scientist covers every point so fully and admir- 
ably, that we take the liberty of appropriating his thunder 
in making this summary. 

Dr. Liceaga states that investigations which have been 
undertaken by historians have never been able clearly 
to determine whether the yellow fever originated in Vera 
Cruz, or was imported from other parts. Many authors 
are inclined to adopt the latter opinion, and especially 
Dr. Charles Heinemann, a distinguished German physi- 
cian, who for many years practised his profession in that 
port, and from whose interesting works Dr. Liceaga took 
many of the data for his paper. However this may be, 
the fact is that Vera Cruz, for more than two centuries, 
has been the most important hot-bed of yellow fever in 
the whole coast. From this point the troops started in 
1813, and introduced the disease for the first time in the 



MEXICO. 701 

port of Tampico. The epidemics which ravaged the same 
port in the years 1847-48, and in 1863-64, owe their origin 
to the same circumstances. In the same way, the disease 
was carried to Tuxpan in the year 1863, and to Jicaltepec 
in the years 1861 and 1868. 

In Vera Cruz the greater part of the epidemics take 
place in the summer time, between March and October; 
but on some occasions, as in the years 1867-68, and in 
1877-78, the epidemics raged through the winter. 

According to Dr. Heinemann, the port of Alvarado, sit- 
uated eighteen leagues to the southeast of Vera Cruz, and 
near the mouth of the Eiver Papaloapam, is another cen- 
ter of the disease. 

Tlacotalpam is a city situated on the left bank of the 
same river, and at a distance of twenty-five miles from 
Alvarado. It is also considered as a cradle of yellow 
fever. 

Laguna is the principal town on the Island of Carmen, 
and derives its importance from the exportation of dye- 
wood's. This is another permanent center of the disease, 
which causes numerous victims, every year, among the 
foreign sailors. 

Campeche is the capital of the state of the same rfame, 
in the peninsula of Yucatan, and is another source of 
yellow fever 'at those times when federal troops are sta- 
tioned here, proceeding from the more elevated parts of 
the country, or from abroad. This happened in the year 
1865, when two companies of Austrian troops lost the 
greater part of their numbers through yelloAv fever. 

The City of Merida, capital of the State of Yucatan, 
which covers the northern part of the peninsula of the 
same name, as well as the districts comprised Avithin that 
state under the name of Unucma, Progreso, Temax, Tizi- 
min and Valladolid are considered as centers of yellow 
fever by Dr. Jose Palomeque, a distinguished physician 
of Merida, and who declares that the disease in that place 
finds its greatest development amongst the foreigners who 
have not already had it, the natives of the elevated table- 
lands in the central part of the republic, and the Indians 
from the other towns of the same state. 



702 HISTORY OF YELLOW FEVBR. 

To the districts of the states of Yucatan above men- 
tioned, Dr. Domingo Orvananos, in his recent work, adds 
the districts of Motul and Mazcanu as being centers of 
yellow fever. 

The preceding lines will have demonstrated that in the 
Gulf of Mexico, and out of a length of 2,580 kilometres 
of coast, only that small part belonging to the canton of 
Vera Cruz, to the district of Frontera, to Campeche, and 
tlie northern coast of the peninsula of Yucatan, can be 
considered as centers of yellow fever, as they are in con- 
stant communication, by sea, with each other, and with 
the Island of Cuba. It is to be noted that these last 
mentioned localities are only separated from Cuba by a 
narrow strait, and that it is natural to suppose that the 
disease was originally imported from that island. 

In contrast to the narrow limits of the centers of in- 
fection, we can present the enormous coast line of the 
Gulf, and of the Pacific, where yellow fever prevails only 
transported from those places in which the disease pre- 
vails in an endemic form. 

Along the Pacific Coast. 

The port of Matamoros, situated opposite Browns- 
ville, United States, has suffered from epidemics of 
yellow fever in the years 1858, 1863 and 1867. 

Altamira went through its first epidemic of black vomit 
in the month of October, 1821, shortly after the arrival 
in that port of a vessel from Havana. More than fifteen 
hundred persons, both native and foreign, succumbed dur- 
ing the ravages of the epidemic. 

Tampico, situated on the left bank of the river Panuco, 
was visited, as previously mentioned, by its first epidemic 
of yellow fever in the year 1813, twenty years after its 
fouudation. 

Tuxpan, on the left bank of the river of the same name, 
was visited by an epidemic in the year 1838, which was 
not repeated until the year 1863, and was then imported 
by vessels arriving from Vera Cruz. It attacked the 
natives of the locality, the Mexicans newly arrived from 



MEXICO. 703 

the table-land and foreign sailors, and it afterwards 
spread to the villages of Jico and Huauchinango. 

Papantla and Misantla were visited by an epidemic of 
yellow fever of the most deadly character, which w^as im- 
ported by the troops passing through those districts dur- 
ing the revolution of 1876. 

Naulta was visited by the epidemic in 1859 ; Jicaltepec, 
in the years 1861 and i868. 

Trusting to the information given by Dr. Heinemann, 
below is given a list of the following towns in which yel- 
low fever has never appeared within the memory of man: 

Santecomapan, La Barilla, Cupilguillo, Dos Bocas, 
Chiltepec, San Pedro y San Pablo, Barro del Kio Palizeda 
and Champoton. According to many other numerous and 
reliable reports, the foreign sailors in these ports have 
hitherto escaped the disease, in spite of the hard work 
they have to perform under a burning sun, receiving and 
stowing the goods with which the ships are loaded. 

Coatzacoalcos and Minatitlan were invaded by the epi- 
demic in September, 1892, imported by persons who had 
arrived from Vera Cruz in the steamer Maij. 

Frontera has from time to time been visited by mild 
epidemics, which have attacked both natives and for- 
eigners. 

San Juan Bautista de Tabasco had never been visited 
by yellow fever until the year 1877, when it was imported 
by the troops under the command of General Enriquez, 
coming from Campeche, and touching in Frontera. 

The disease attacked the inhabitants of this town, with- 
out distinction of race, and afterwards spread to Micalte- 
pec, Huimanguillo, San Antonio, Cardenas, Nacayuca, 
Jalapa, Pichucalco. Doctor Castanares, who has lived in 
that locality, believes that the Mexicans who are natives 
of the old country, and those of the neighboring State 
of Chiapas, are the first to be attacked by the epidemic, 
while it respects the natives of the State of Tabasco. 

During the construction of the Vera Cruz-Mexico Rail- 
road, and as the works advanced, the disease presented 
itself in all the stations excepting that of Tejeria, 
although it is onlv situated at a distance of fifteen kilo- 



704 HISTORY OF YELLOW FEVER. 

metres from Vera Cruz. This station preserves its im- 
munity to this day, while in La Soledad, El Camaron, 
Paso del Macho and Atojac, a few cases of yellow fever 
are observed almost every year. 

But the city situated on this road in which the epidemic 
has presented itself on several occasions, and where it has 
carried off the largest number of victims, is Cordova. 
Situated at a distance of 105 kilometres from Vera Cruz, 
and at an altitude of 827 metres above the sea level. It 
has undergone epidemics imported from that port, in the 
years 1866-67, 1876-77, 1880-81 and 1892-93. 

In the year 1876, more than two thousand persons per- 
ished in the epidemic, which spread to many of the neigh- 
boring towns and villages. 

Following the ways of communication by the road from 
Vera Cruz to Jalapa, the epidemic was carried to the 
towns of San Juan and Paso de Ovejas, but did not reach 
Jalapa, which is almost at the same distance from Vera 
Cruz as Cordova, but at an elevation of 3,960 feet above 
the sea level. This is the highest point in which the yel- 
low fever has, up to the present date, been found sus- 
ceptible of development. 

The extensive coast of the Pacific had always enjoyed 
an immunity, from this epidemic, with the exception of 
short stretches belonging to the States of Michoacan, 
Oaxaca and Chiapas, which on two distinct occasions had 
been visited by yellow fever. 

In the localities mentioned below, all memory had dis- 
appeared of an epidemic of this class, if they ever had 
known such a thing, so that when it presented itself in 
Mazatlan, the local physicians did not recognize it, believ- 
ing that it was not a disease special to that climate. 
Nevertheless, in August, 1883, the Pacific mail steamer, 
San Juan, arrived with sick people on board, who im- 
ported yellow fever in Mazatlan. The epidemic spread 
with such rapidity that within five days, three thousand 
persons were attacked with the disease. From Mazatlan 
it extended to Guaymas, San Bias, Acapulco, Manzanille 
and other places. Among these latter, I would especially 



MEXICO. 705 

mention Culiacan and Herniosillo on account of the dis- 
tance at which they are situated from the coast. The epi- 
demic ceased in the month of October, in the same year, 
and has never been repeated. 

General Retrospect. ,, 

From the preceding remarks, it will be seen that the 
immense coast of the republic washed by the two oceans, 
is always liable to be invaded by epidemics of yellow fever 
when it is imported. 

Matamoros was visited by epidemics in the years 1858, 
1863 and 1867. 

As we have already seen, the epidemic appeared in Alta- 
mira during the year 1821, after the arrival of a vessel 
from Havana. 

The first epidemic was carried to Tampico in the year 
1843, by troops from Vera Cruz. 

To the same circumstance we attribute the great rav- 
ages among the American troops in 1847-48, who gar- 
risoned that town during the war. 

The epidemic, was also imported into Tampico during 
the years 1863-64, by two battalions of the French army. 
The great epidemic that ravaged Tampico in September, 
1878, was imported from Nev\^ Orleans. 

In June, 1879, yellow fever was again imported to 
Tampico, and caused an epidemic which lasted until the 
month of December. 

From that date no nCAV epidemic has appeared in Tam- 
pico, although isolated cases have been observed in per- 
sons who carried the disease with them from Vera Cruz. 

Tuxpan vras visited by an epidemic in the year 1838. 
Dr. Ordozgoiti does not state how the epidemic was 
brcmght to the town, but he clearly declares that the 
epidemic of 1863 was imported from ships arriving from 
Vera Cruz. Muleteers carried the disease as far as Jico 
and Huauchinango. Troops arriving at Tuxpan from 
Vera Cruz introduced the epidemic in the years 1877 
and 1878. 



70(5 HISTORY OF YELLLW FEVER. 

Papantla : A detachmeiit of trot^ps passing through 
this town in the year 1876, brought an epidemic of yellow 
fever with them which deTeloped the most deadly char- 
acteristics. 

Nautla : An epidemic took place here in the year 1859. 

Jicaltepec : An epidemic appeared in this town in the 
year 1861, which Avas limited to the right bank of the river 
Nautla. It was also visited by an epidemic in the year 
1868. 

Coatzacoalcos: The yellow fever was carried to this 
port in the month of September, 1892, by some sick men 
on board the steamer May, from Vera Cruz. 

Minatitlan : The disease was carried to this port at 
the same time and under the circumstances as the one last 
mentioned. 

Frontera : From time to time mild epidemics are ob- 
served in this town, the disease affecting both foreigners 
and natives alike. 

San Juan Bautista : An epidemic raged in the year 
1877, having been imported by Mexican troops which had 
touched at Frontera on their way from Campeche. From 
San Juan Bautista the epidemic spread to Micaltepec, 
Huimanguillo, San Antonio, Cardenas, Nacayuca, Jalapa 
and Pichucalco. 

Dr. Castanares, who practiced his profession for twenty- 
three years in Tabasco, says that the epidemics only 
appear in that state when there occurs a great crowding 
of people under unhealthy conditions, as for instance, in 
a military encampment. Dr. Castanares believes that the 
epidemic attacks with .ereater facility the natives of the 
neighboring State of Chiapas. According to Dr. Orvan- 
anos, epidemics of vellovr fever have visited the State of 
Yucatan in the years 1855, 1857, 1881-82 and 1883, and 
have also appeared in the State of Vera Cruz in the 
years 1863, 1872, 1873, 1875, 1878 and 1879. and in Cam- 
peche in the vear 1865. Tlie author does not giye any 
details as to the manner in Avhich the epidemics developed 
themselves. 

Dr. Orvananos speaks of epidemics having appeared in 
the State of Michoacan, during the years 1813, 1814 and 



MEXICO. 707 

1860, but this can only have taken place along a short 
stretch of coast, as no record can be found of these epi- 
demics. The same remark applies to the state of Oaxaca 
during the years 1850 and 1857. 

The General Epidemic of 1883. 

The epidemic which spread during the year 1883 along 
the entire coast of the Pacific, is of the greatest interest. 
If any previous epidemics had ever appeared, the memory 
of them wa,s so completely lost, that when tlie first cases 
of yellow fever presented themselves in the port of Maz- 
atlan, the physicians did not recognize them, founding 
their doubts on the fact that this disease had never been 
on the west coast of Mexico. Another great point of in- 
terest presented by this special epidemic, is found by fol- 
lowing up the Avay in which the disease was introduced, 
that is to say, Dr. Praslow maintains that the yellow 
fever may have been imported, from the year 1882, by the 
steamers of the Pacific mail, which brought yellow fever 
patients from Panama, who did not land. He proves this 
assertion by letters from persons who had traveled in the 
steamer Colima, on board of which the captain and six 
stewards fell sick. 

The same did not happen in August, 1883. In that 
month the steamer ^an Juan, belonging to the same com- 
pany, reached Mazatlan with thirty-three sick people on 
board, coming from Panama. Some of them landed, and 
the consequent epidemic spread with such force that, a^ 
before said, more than three thousand people Avere at- 
tacked in the port within the first five days, while twenty- 
two died in one day. The epidemic rapidly extended it- 
self to other ports on that coast, and visited the ports of 
La Paz, Guaymas, Altata, San Bias, Manzanillo, San- 
tiago, Acaponeta, Puerto Angel, Salina Cruz, Tonala, 
Soconusco, Tapachula and San Benito and in the interior 
at Hermossillo and Culiacan. A very important fact to 
be borne in mind is, that in all the territory included be- 
tween the Yaeiui and ^Mayo Elvers, which is inhabited by 
Yaqui Indians, the epidemic did not put in an appear- 



708 HISTORY OF YELLOW FEVER. 

aiice. This was due to the energetic attitude assumed by 
the chief of the tribe, who prohibited all communication 
with the outside Avorld, either by sea or land, under pen- 
alty of death. 

HISTORY OF YELLOW FEVEE IN MEXICO, BY 
LOCALITIES. 

ACAPULCO. 

• 

1853. Yellow fever was imported to Acapulco by a 
vessel coming from Guayaquil, Ecuador, in 1853, for the 
first time in its history. About sixty cases resulted. 

1883. Thirty years^ later (1883),\'efugees from Maz- 
atlan infected Acapulco. The disease prevailed quite 
extensively. 

1887. in April, 1887, a case of yellow fever was 
brought to Acapulco and died on the 17th. Source of in- 
fection not stated. There was no spread. 

1895. A vessel from Panama brought a case of yellow 
fever to Acapulco on September 8th. Death on the 15th. 

189G. Three cases in 1896 completes the history of yel- 
low fever in Acapulco. 

ACAYUCAX. 

1902. A case of yellow fever was brought to xVcayuacan 
from Vera Cruz in 1902. The patient recovered. 

ALTATA. 

Altata v\^as infected by refugees from Mazatlan in 1883. 
The disease prevailed epidemically. The r-umber of cases 
could not be ascertained, but the deaths were 1,981. Of 
150 soldiers stationed in the town, 148 had the fever; 17 
died. 

ALTAMERA. 

1821. Altamera, which was an important port previous 
to the foundation of Tampico (1821), is now a place of 
minor importance, the new city having taken away its 



MEXICO. 709 

commercial prestige. Yellow fever was observed for tlio 
first time in Altamera in 1821. The infection was brought 
from Havana in October, and an extensive epidemic re- 
sulted. The mortality was 1500. 

1903. Yellow fever broke out in July. The outbreak 
was neither severe nor extensive. 

ALVAIIDO. 

1902. Three cases of yellow fever were observed in 
Alvarado in 1902. The infection came from Vera Oruz. 

AMALCO. 

1899. Sporadic cases. 

ATAI. 

1883. Atai, in Sonora, near the borders of Arizona, 
suffered to a considerable extent from yellow fever in 
1883. No statistics are given, but it is stated that there 
were ^'several thousand cases/' and that the mcrtality 
went into the hundreds. 

CAMARGA. 

1882. The village of Camarga, three miles from Rio 
Grande City, which had a population of 300 in 1882, was 
infected in September, by refugees from Matamoras. The 
virulent nature of the fever may be judged from the fact 
that out of this small population, there were 225 cases, 
of which 33 died. 

CAMPECHE. 

1865. Yellow fever was epidemic in 1865. No reliable 
details are available. 

1883. Yellow fever ^^as carried to Campeche " by a 
Norwegian vessel" in 1883. Beyond this statement, no 
other information is given. 



7 10 HISTORY OF YELLOW FEVER. 

CAEDENAS. 

1877. Cardenas was infected by refugees from San 
Juan in 1877. Developments were unimportant. 
1903. In July, 1 fatal case. 

CHILPANZINGO. 

1853. Eefugees from Acapulco carried yellow fever to 
Chilpanzingo, capital of the State of Guerrero, in 1853. 
No details obtainable. 

1896. At the end of August, 1896, and without any 
antecedents whatever, two cases of a disease, which at 
once spread itself and which at first was diagnosed under 
tJie name of yellow fever, simultaneously appeared in 
different places, remote from each otheT, in Chilpanzingo. 
The malady assumed a most alarming character, in view 
of the limited extent of the town and the small number 
of its inhabitants, and because it indistinctly attacked 
persons belonging to all social classes. 

The Mexican Board of Health immediately ordered Dr. 
Yglesias, an authority on yellow fever, to proceed at once 
to Chilpanzingo for the purpose of making an exact diag- 
nosis of the disease. After a careful investigation, the 
doctor reported that the epidemic in question was a man- 
ifestation of grave paludism; but as the military physi- 
cian then resident in the town was of a contrary opinion, 
it was decided that Dr. Mejia, Professor of Clinics in 
the National School of Medicine, Mexico, should join Dr. 
Yglesias for the purpose of making a study of the epi- 
demic. Dr. Mejia was accompanied by Drs. Beristain 
and Loeza, who took with them the necessary instruments 
for a microscopical study of the blood of the fever patients, 
and for the forwarding of the blood under the conditions 
that would facilitate cultivation under proper means in 
the laboratory of the Board of Health in the City of 
Mexico. 

The Commission presented three reports, in which it 
was shown that the epidemic in question was produced 
by the hematozoria of Laveran. 



MEXICO 7 1 1 

1899. A few sporadic cases of yellow fever observed in 
September. 

OILAS. 

1903. Yellow fever was imported to Cilas in 1903 for 
the first time in its history and raged for two months — 
xlngust 25 to October 24. A total of 148 cases, of which 
56 died, is recorded. 

CINCHAPA. 

1899. YelloAv fever broke out in Augnst. Only 
sporadic cases were observed. 

CLINIDAS. 

1903. Yellow fever claimed 60 victims in Clinidas in 
1903. The number of cases not stated. 

COATZACOALCOS. 

1892. The steamship May, from Vera Cruz, brought 
yellow fever to Coatzacoalcos in 1892. Only a few cases 
resulted. 

1900. Sporadic cases in May. 

1902. Kefugees from Vera Cruz infected Coatzacoalcos 
in 1902. Forty-two cases are recorded; deaths not stated. 

1903. Six cases; 3 deaths. 

1904. Six cases; 1 death. 

1905. Six cases ; 2 deaths. 

COLINA. 

1884. 

Yellow fever suddenly broke out in Colina in August, 
1884. How the disease originated, authentic information 
is lacking; but that it was imported there is no doubt, 
as this thriving Mexican town had never suffered from 



/ 1 2 HISTORY OF YELLOW FEVER. 

a visitation of the disease before. T]je infection probably 
came from Manzanillo, fifty miles distant, on the Pacific 
coast. 

When the 30,000 inhabitants of Colina realized that 
they were face to face with an epidemic of the dreaded 
vomito, terror and consternation seized them. Inside of 
a week, 10,000 had fied to the surrounding country, where, 
unfortunately, the spread of the infection helped to 
swell the frightful mortality which characterized the Mex- 
ican epidemic of 1884. In two months, more than 1,000 
died in Colina alone, among whom were some of its best 
citizens — the chief justice of the '^superior tribuna de 
justicia," a lawyer of some national reputation and his 
wife, the federal district attorney, a colonel of the federal 
troops, his son and daughter and scores of other promi- 
nent people. The houses were closed, the city deserted, 
the streets lifeless (save for the lumbering funeral carts) 
and business paralyzed. At one time, the new cases were 
in the hundreds and the mortality from 15 to 20 every 
twenty-four hours. 

Complete statistics could not be obtained, but as the 
mortality is said to have been about 1,000, there certainly 
must have been at least 10,000 cases, as hardly a house- 
hold escaped invasion. And, even to this day, the inhabi- 
tants of the beautiful mountain city, speak with a shudder 
of the '^great epidemic,' and mourn the loss of some dear 
relative who fell victim to its baneful influence. 



CAKACO. 

1883. 



The City of Caraco, in the State of Jalisco, suffered 
greatly during the epidemic of 1884. Statistics, which 
also include the neighboring town of Gualian, place the 
number of cases at 3,000, with a mortality of 521 within 
the space of three months. 



MEXICO. 713 

CONCOKDIA. 

1883. 

Concordia, in Linaloa, suffered severely, an average of 
three cases daily being recorded during the height of the 
epidemic, a period of three months. Complete statistics 
not obtainable. 

CORDOVA. 

Cordova is 66 miles west of Vera Cruz, and has about 
5,000 inhabitants. This history of the epidemics of yel- 
low fever which have from time to time decimated the 
town is taken from the elaborate paper read by Dr. Men- 
dizabal, of Vera Cruz, at the 1896 meeting of the Amer- 
ican Public Health Association and brought up to date 
by the compiler of this work. It is to be regT-etted that 
no statistics are given showing the cases and deaths in 
these epidemics. 

The City of Cordova is situated on the boundary of the 
yellow fever zone, near the railway which connects Vera 
Cruz with the City of jVIexico, and on the margin of the 
old high road. 

The city was founded in the seventeenth century, and 
there is no record or knowledge of any epidemic of j^ellow 
fever during that century. 

The epidemics of yellow fever in Cordova have nearly 
always commenced in the autumn, very seldom before the 
end of the summer. It has never been generated there, 
the infection having always been imported from Vera 
Cruz. 

1772. 

The first epidemic of which the date is recorded was in 
July, m the year 1772, and lasted three months. 

1795. 

It reappeared in the autumn of the year 1795, in which 
year five thousand persons were attacked, of whom six 
hundred died. 



714 HISTORY OF YELLOW FEVER. 

1796-1800. 

During the years 1796, *97 and "98, some isolated cases 
continued to occur, but the epidemic faded in the years 
1799 and 1800, being a total during the eighteenth century 

of two great epidemics and four small ones. 

1801-1860. 

During 1801 and 1802, the epidemic which existed at 
the end of the previous century continued under the form 
of a small epidemic, which in 1803 took the character of a 
large epidemic, soon subsiding into small epidemics, which 
appeared at irregular intervals in the vears 1805, 1809, 
1813 and 1818, '21, '21, *51 and '60. 

1865-1867. 

In the year 1865, in the month of June, there was a 
great epidemic, which ceased during the winter and re- 
appeared in the summer of the year 'QQ, and faded in the 
autumn of the same year. Sporadic cases in 1867. 

The frequency and gravity of the epidemics date from 
the year '65, which was the period of the principal work 
for the construction of the Mexican Kailroad from Vera 
Cruz to the City of Mexico. 

The frequent and severe outbreaks at this epoch are 
easily explained when we consider the conditions existing 
in Cordova at that time; viz.: an accumulation of un- 
acclimatized persons living under the worst possible con- 
ditions of hygiene; the rapid and frequent communica- 
tions with Vera Cruz; the neglect of all precautions, 
especially in not isolating the sick persons immediately on 
their arrival, each of whom became a center of infection. 

These circumstances combined, formed elements of 
combustion of the worst form ; all the ensuing misery, the 
result of neglect of timely precaution, might have been 
avoided by stopping the lodgment of that spark, or suf- 
focating it at its birth. 



MEXICO. 715 

1875-1882. 

The same circumstances were observed during the years 
^75 and '76, and the Tears '81 and '82. Total for the 
nineteenth century seven great and sixteen small 
epidemics. 

1893-1896. 

Sporadic cases were observed in 1893 and 1896. 

1899. 

This is the first instance in which reliable statistics 
were obtained. The epidemic broke out in May. Be- 
ginning with the 10th of May, the following number of 
casci^ was reported : 

May 8 cases. September 197 cases. 

June 37 " October 132 " 

July 90 " November . , 39 " 

August 220 '' December 7 " 



Total 730 

The mortality was 350, making a death-rate of 48 1/2 
per cent. Eleven per cent, of the inhabitants werei 
attacked. 

1902. 

Limited outbreak, a total of 13 cases being recorded. 

1905. 
Five cases; 1 death. 

1906. 

Sporadic cases in January. 

COKRIENTES. 

1883. 
Limited outbreak. 



716 HISTORY OF YELLOW FEVER. 

COSMALOAPAM. 

1899. August 21, 1 imiDorted case; recoyery. 

1902. April 11, 1 case, imported from Vera Cruz; 
recoyery. 

COSALA. 

1883. Sporadic cases. 

CULICAX. 

1883. Infected by refugees from Matanzas, in Sep- 
.tember. The mortality was three daily to October 1, 
after which date it went as high as nine daily for a while. 
Complete statistics not obtainable. 

DOFIA CECILIA. 

1903. Between July 15 and Xoyember 1, two cases of 
yellow feyer were imported to Dofia Cecilia. There was 
no spread of the disease. 

EL HIGO. 

1903. August 15. Sporadic cases. 

EQUADOE. 

1853. Equador was infected by Acapulco in 1853. The 
outbreak was not extensiye. 

FKONTERA. 

1895. A fatal case of yellow feyer was obseryed in 
Frontera in 1895. It was imported from the surrounding 
country. 

1902. One case, imported from Tabasco. 



MEXICO. 717 

GUALIAN. 

1883. Gualian suffered considerably from yellow fever 
in 1883. The total number of cases and deaths could not 
be ascertained, but the former were considerable and the 
latter went into the hundreds. The garrison, which con- 
sisted of 600 soldiers, was nearly decimated, 150 falling 
victims to the pestilence. An opera company of 31 mem- 
bers lost 25. Out of eight doctors, two died. 

GUAYMAS. 

1883. Guaynias was infected by refugees from Maz- 
atlan in 1883 and suffered the first yellow fever visitation 
in its history. The epidemic was so severe, that many 
perished from want of attendance, the dead being buried 
by the carload by Indians. The fever was particularly 
fatal to Americans in the employ of the railroad company. 

1881. Eecrudescense of the epidemic. 
1885. Sporadic cases observed. 

1891. Yellow fever reported as epidemic in August. 
1895. Yellow fever reported present on May 20. 

GUEKREEA. 

1882. One case; recovery. Imported. 

GUICHICORI. 
1902. One case. Imported. 

HERMOSILLO. 



1883. The extensive epidemic of 1883 reached Her- 
mosillo in August and lasted until the beginning of 
November. At times the mortality mounted! up to twenty 
dailv. 



7 '8 HISTORY OF YELLOW FEVER. 

HIDALGO. 

1899. Sporadic cases in August. 

HIJACHINANGO. 

1863. Sporadic cases. Imported. 

HUIMANGUILLO. 

1877. Infected by San Juan. Sporadic cases. 

IXCALLAN. 

Ixcallan, which had then a population of 13,000 suf- 
fered for the first time in 1883. During the height of the 
epidemic, 33 cases were reported daily. The mortality is 
not stated. 

JALAPA. 

1877. Yellow fever imported from San Juan. Limited 
outbrtalr. 

1B99. Five deaths in August. Imported. 
1902. Infected by Vera Cruz ; 27 deaths. 

JICALTEPEC. 

1861. Infected by Vera Cruz. Epidemic confined to 
right bank of the [N^aulta River. 

1868. Infected by Vera Cruz. Limited epidemic. 

JICO. 

1863. Jico was infected by muleteers from Tuxpan in 
1863. Limited outbreak. 

JIMIXEZ. 

1898. Sporadic cases in September. Imported. 



MEXICO. 719 

JOLTIPAN. 
1904. Sporadic cases. Imported. 
JUCHITAN. 

1899. Sporadic cases. Imported. 

LAGUNA DEL OAEMEN. 

1894. Sporadic cases. 

1900. Several cases and one death in March. 

1902. One case; imported from Campeche. 

1908. Five cases and three deaths in May, on bark 
Leml)it, from Tucacas, Venezuela. The disease did not 
spread to the town. 

LA JUNTA. 

1899. Sporadic cases. 

LAMPASAS. 

1903. Five deaths from yellow fever between October 
1 and December 31. 

1904. Sporadic cases; imx3orted. 

LA PAZ. 

1883. The great yellow fever epidemic of 1883, which 
committed ravages on the Pacific Coast of Mexico, was 
brought to La Paz, a town of about 2,000 inhabitants, in 
Lower California. About 1,000 cases resulted. The type 
of the disease was not very severe, only 71 deaths being 
recorded. 

1895. La Paz was visited by yellow fever for the sec- 
ond and last time in its history in 1895. The outbreak 
was limited to 3 cases, all imported from Mazatlan. 



720 HISTORY OF YELLOW FEVER. 

LAS ANIIJAS. 

Yellow fever has been observed in Las Animas on one 
or two occasions, but the exact date could not be as- 
certained. 

LINAEES. 

1903. Linares is situated in the State of Nueva Leon, 
35 miles southeast of Monterev, and has a population of 
6,000. Yellow fever was imported to this town in 1903, 
and from August until the end of the epidemic (Decem- 
ber), there were 2,011 cases, of which 366 died. 

1901. Sporadic cases. 

MANZANILLO. 

1883. Manzanillo, wliich had a population of 76,000 in 
1883, was visited by a disastrous epidemic of yellow fever 
that year. No reliable statistics could be obtained. In- 
fection came from Mazatlan. 

1881. Sporadic cases. 

1896. Sporadic cases. 

1902. One case; imported. 

1907. One case, on steamship San Juan. 

MATAMOEAS. 

Matamoras is situated on the Eio Grande, opposite 
Brownsville, Texas, 10 miles from the Gulf of Mexico, and 
has a population of about 25,000. Owing to its close 
business relations with Brownsville, whenever yellow 
fever prevailed in IMatamoras, it was invariably brought 
to the American city. 

Summary of Epidemics. 

1853. In 1853 Matamoras had a population of 6,500. 
Yellow fever was introduced into the town on September 
22 and raged epidemically until the end of the year. Iso 



MEXICO. 721 

statistics were kept of the number of cases, but the mor- 
tality is recorded at 322. Source of infection not stated. 

Infection carried to Brownsville, Texas, (deaths, 50). 

1858. Mild epidemic. No statistics. Brownsville in- 
fected (deaths, 41). 

1863. Mild epidemic. No statistics. 

1867. Mild epidemic. No statistics. 

1882. Severe epidemic. No statistics. BroAvnsville 
infected (1,072 cases; 63 deaths). 

MAZATLAN. 

Mazatlan is an important commercial port of Mexico, in 
Cinaloa, on the Gulf of California, and has a population 
of about 15,000 souls. Previous to 1883, in common with 
other localities on the Pacific Coast, Mazatlan had never 
experienced yellow fever. 

Summary of Epidemics. 

1883. The steamship San- Juan, from Panama, brought 
yellow fever to Mazatlan in August. The Italian Opera 
Company, which was to open the season, had just landed. 
Paralta, the prima donna, and seventeen members of her 
company, contracted the disease and died at the Hotel 
Iturbide. The epidemic lasted until December, causing 
500 dearths. 

1881. Reappearance of yellow fever, but not extensive. 

1885. In July and August, sporadic cases. 

1895. Sporadic cases in September. 

1897. September 26 to October 2, sporadic cases; 9 
deaths. 

MERIDA. 

Merida, capital of the State of Yucatan, has a popula- 
tion of about 50,000. It is 26 miles south of Progreso, 
with which it is connected bv rail. 



722 HISTORY OF YELLOW FEVER. 

Summary of Epidemics. 

1880. One case, imi^orted ; deatli, January 31. 

1887. May 11 to Angnst 2, six deaths. 

1888. January 26, one death. 

1890. Twelve cases reported in June; total cases and 
deaths not stated. 

1891. Two cases in January. 
1891. One death. 

1895. Three cases; no deaths. 

1898. Seven deaths. 

1899. One death, Treek ending July 1. 

1900. Seven cases and four deaths in Jtily. 

1901. June 11 to September 28 ; sixteen deaths. 

1902. Nineteen cases; eight deaths. 

1903. January 1 to December 5, 211 cases; 85 deaths. 
1901. June 13 to December 3, 119 cases, of which 39 

died, distributed as followed: 



Xationality Cases. Deaths. 

Mexican..' 11 19 

Italian 6 4 

Spanish 50 13 

Turk 12 2 

English 1 

American 3 ,0 

Porto Eican 1 

French 1 

Greek 1 1 

Total 119 39 

1905. January to December, nine cases, of which ^\e 
died. The case in December was imported from Vera 
Cruz on the 23rd, and established a foctis from which 
other cases developed later. 

1906. January 16, the first case occtirred and was 
traced to the focus of December 23, 1905. Cases and 
deaths were as follows: 



MEXICO 723 

Month. Cases. Deaths. 

January 3 3 

February 3 

March . 2 1 

April 1 1 

May 5 3 

June to December 107 63 

Total 121 71 

1907. Two cases and one death in March. 

1908. August 23 to December 26, 69 cases; 25 dea,ths. 

1909. January 1 to March 6, 15 cases; 8 deaths. {At 
the time of going to press, April 15, the epidemic loas 
still in progress) . 

CITY OF MEXICO. 

The City of Mexico, 7,460 feet above the level of the 
sea, is the highest point in the world where yellow fever 
has been observed. The disease has never originated in 
the place, but in every instance was brought either from 
Vera Cruz or towns adjacent to that seaport, and was 
confined to the imported cases. This is fortunate, 
for Mexico has nearly half a million souls, all non- 
immunes, and the importation of a few Stegomyia Galopae 
simultaneously with cases of yellow fever, would result 
in an epidemic whose ravages would undoubtedly be 
appalling. 

Can the Yelloio Fever Mosquito Thrive in Mexico City? 

Can the Stegomyia Calopus, once introduced in th^ 
City of Mexico, where it is now a stranger, be acclima- 
tized? This momentous question has been agitating the 
scientists of the entire civilized world since the adoption 
of the Mosquito Doctrine of the transmission of Yellow 
Fever. 

Drs. Fernando Lopez, of Mexico City, and Narcisso del 
Eio, of Vera Cruz, made special studies in this direction, 



724 HISTORY OF YELLOW FEVER. 

and gave the result of their labors in an elaborate paper 
read by Dr. Lopez at the Havana Meeting of the American 
Pnblic Health Association in 1905. The statistics pre- 
sented prove that the Stef/orrtjjia CaJopus race of mos- 
quitoes have thrived in altitudes hitherto thought to be 
antagonistic to its existence since the construction 
of railroads throtighout the Kepublic and that though 
until lately it was admitted that these insects cotild not 
be found except in some places on the coast, the facility 
and rapidity of communication have acclimated them in 
places more or less distant and in more or less elevated 
alitudes, thus enlarging the Yellow Fever Zone. 

That the spread of yellow fever to localities in Mexico 
where it was hitherto unknown, can be jDlaced at the 
doors of the railroads, is made clear by the following 
deductions arrived at by these eminent scientists : 

Along the Mexican Eailroad, it has been observed that, 
from time to time, yellow fever was spreading, first 
to Cordova, which has an altitude of 2,481 feet above 
the sea level. It did not pass the limits of that station 
until 1899, when an epidemic broke out in Orizaba, 3,681 
feet above the sea level. 

Along the Interoceanic Eailroad, it has been observed 
that the Ster/oaujia Calopii.^ has been aacclimating itself 
from station to station, until it reached Carrizal station, 
with an altitude of 2,181 feet above the sea level. 
Similar cases have been noted in the states of Tamaulipas 
and Xuevo Leon, where the traffic of the railroads have 
facilitated the enlarging of the Yellow Fever Zone. 

Having come to an agreement with Dr. del Eio, Dr. 
Lopez formed the following program for a careftil study 
of the question : 

1st. To investigate if the ><tcf/omj/ia larvae brought to 
Mexico City would hatch into mosquitoes, and in case 
they should, to see if these would live, if they wotild bite 
and reproduce. 

2nd. To investigate if the adult mosquito brought 
from Vera Cruz to Mexico City will live, bite and re- 
produce. 



CITY OF MEXICO, 725 

3rd. To invest igate if the mosquitoes infected with 
yellow fever biting a person in Mexico City, who was non- 
immune will produce the disease, if it presents the same 
characteristics which it does on the coast, and if an 
immunity may be found. 

In order to solve the first part of the problem, Dr. del 
Eio sent Dr. Lopez from Vera Cru.z a flask containing a 
multitude of i^tcr/omyia larvae, which were received in 
Mexico City on June 24, 1905; the larvie, were collected 
from a deposit of water in a house in Vera Cruz, and were 
preserved in the same water. 

The larvie were placed in a fine wire cage 50 cm. in 
height, 30 cm. in length and 40 cm. wide, having an iron 
sheeting floor and roof. In one side of the cage there was 
an opening over which was sewed a cloth bag through 
which the hand might be put into the cage without fear 
of letting the mosquitoes escape. 

The cage was placed in an ample, well ventilated room 
where there was sufficient light. 

The mosquitoes which began to hatch out in great num- 
bers were fed on bananas, the juice of which they greedily 
sucked out. When there were quite a number of mos- 
quitoes four or five days old. Dr. Lopez put his hand into 
the cage through the opening already mentioned, and 
with no little surprise saw that the females rushed to it 
and, raising their bills, bit him greedily. This was some- 
thing the doctor was not prepared to expect, owing to 
the statements which have been admitted heretofore, that 
the Stegomj/ia loses its iDower of biting when it is found 
in an altitude of more than 6,000 feet above the sea level, 
and ^lexico City is more than 7,300 feet high. Watching 
the mosquito, the doctor could easily see that its abdomen 
was filled with blood, after which it would retire. 

The sting was painful, forming a pimple which lasted 
from Aye to six days and produced an insupportable itch- 
ing. Dr. Lopez repeated this experiment various times, 
always obtaining the same results. 

In order that the mosquitoes might reproduce, Dr. 
Lopez put a bowl of water which contained some little 



726 HISTORY OF YELLOW FEVER. 

pebbles barely coming up out of the top of the water 
into the cage. He did this with the object that the 
females which had sucked the blood might find a place 
to deposit their eggs. A few da^^s later, he was convinced 
that this had happened; for using a lens, he could see 
a certain number of isolated eggs upon the surface of the 
water, which were of a blackish color. Then he took out 
the bowl containing the eggs and put it in another cage, 
in order to observe them better; in ten days, the eggs 
had been converted into larvae, which hatched into 
mosquitoes, thus constituting the second generation of 
^tegomyia bred and hatched in Mexico City. 

Only a few mosquitoes were obtained in this way, for 
an unlocked for accident overturned the receptacle in 
which the doctor had placed the larvae, unfortunately 
causing the death of all that remained. These mosquitoes, 
even when the investigator had put them in conditions 
which he thought favorable for their reproduction, died 
without leaving any young. They retained the power of 
biting as long as they lived. 

On the 8th day of August of the same year (1905), two 
other flasks containing larvae arrived from Vera Cruz, 
having been sent by Dr. del Eio. That Dr, Lopez might 
change somewhat the conditions of the former experiment, 
he put these larvae in wooden cages covered with tarltan. 
Very soon the mosquitoes began to hatch, and as soon as 
each one was hatched they were passed over into a new 
cage of the same kind, in order to observe them minutely. 
Three days after they were hatched they began to bite. 
Dr. Lopez had then observed friendly struggles between 
the females and the males. 

On the first day of September, the experimenter ob- 
served that there were already many groups of eggs, which 
transformed into larvae and the latter into mosquitoes, 
notwithstanding the fact that the temperature had 
descended to 15 degrees centigrade in the room in which 
he placed them for observation. He preserved many 
larvae until the middle of December, the date in which 
this was written. From this last generation no eggs were 



CITY OF MEXICO. 7Si7 

secured, wliicli was probably due to the fact that winter 
had set in. 

The temperature and the degree of dampness of the 
air in the room in which the mosquitoes were, w^as from 
the beginning of the experiments taken regularly, and 
was found to vary between 15 and 21 degrees centigrade 
for the former ; the latter between 50 and 70 degrees. 

Haying for his object the study of isolated mosquitoes, 
specimens were placed in proof tubes, closing the entrance 
with a simple gauzy material every day. At different 
hours of the day, the doctor applied the mouth of the 
tube to his bared arm, to observe the mosquito while it 
Avas biting. With this system he saw that the mosquitoes 
bite the same at night as in the day, and that they do 
not do it except every three or four days. The mosquitoes 
remained alive inside the tubes from 24 to 28 days. 

The doctor also made experiments to determine how 
long the larv?e and pupae Avill live without breathing at- 
mospheric air. He placed some larvae in trial tubes, 
which were completely filled with water and stopped them 
with a rubber, without leaving on the inside the least 
bubble of atmospheric air. The others were closed with 
tarltan and inverted it in a vessel of water so that the 
atmospheric pressure would always keep it full without 
permitting a bubble of air on the inside ; the tarltan kept 
the larvae from coming out. Multiplying these experi- 
ments, Dr. Lopez was able to observe that the larvae lived 
a longer or less time in proportion to their age, varying 
from 12 to 50 hours. The pupae averaged from 40 minutes 
to an hour. 

In all of these experiments, Dr. Lopez observed the fol- 
] owning very curious phenomenon in the larvae pupae: A» 
soon as the larva was shut up in the tube, it would go 
to the top and not finding any air to breathe, it would 
descend slowly, curling itself up until it formed a com- 
plete circle; it would rub the extremity of its breathing 
tube with the tufts of filaments which it has on its mouth, 
with, such violence that one would suppose that it w^as 
trying to remove some obstacle from it, after this it would 



728 HISTORY OF YELLOW FEVER. 

make repeated trials, continuing this operation until its 
death. 

Owing to its form and brisk movements, the pup?e was 
still more interesting. As soon as it reached the top of 
the tube in which it was enclosed and found no air to 
breathe, it descended sIowIt, curying its body backwards 
and with the two flaps at the end of the abdomen eagerly 
brushed its breathing tubes. It repeats these struggles 
with less and less energy until its death. 

These experiments which Dr. Lopez described to the 
American Public Health Association, prove that the 
Stegomijia CaJopus was able to live, bite and breed for at 
least two generations in Mexico City, notAvithstanding the 
fact that the aforesaid city has an altitude of more than 
7,300 feet above the sea level. 

The other two points remain yet to be solved. 

S^niMARY OF ImPORTATIOXS OF YeLLOW FeVER TO THE 

City of Mexico. 

1883. One case; death. 

1898. Between October 10 and 16, sporadic cases; 1 
death. There was no spread of the disease. 

1899. One case; death. 

1900. May 7 to Xovember 23, four deaths from im- 
ported cases. 

1903. August 10 to October 1, four deaths. 
1905. One case, week ending December 2, one case; 
death. 

MICALTEPEC. 

1877. Infected by refugees from San Juan; limited 
epidemic. 

MIER. 

1882. Infected in September by refugees from Mata- 
moras; 28 deaths. 



MEXICO. 729 

MINATILTAN. 

1892. A solitary case, imported by the steamship May, 
from Vera Cruz. No developments. 

MISANTLA. 

1876. Sporadic cases, brought into the town by troops 
from Vera Cruz. No developments. 

MONCLAVA. 



1903. Yellow fever was brought to Monclava from 
Monterey in the beginning of November. The only thing 
which saved the town from a disastrous epidemic was the 
absence of the Stegomijia Calopiis, and the fact the win- 
ter season had already set in and t^e few imported 
Stegomyia did not survive. Monclava is 1,970 feet above 
the level of the sea, and the nights are generally cold, 
even in summer. There were in all 6 cases, of which 4 
died, the last on November 19, with black vomit. On the 
last date, ice was half an inch thick in the town. 

1904. Sporadic cases. No developments. 



MONTEKEY. 



Although Monterey was settled by the Spaniards in 
1568, yellow fever has been observed in the city on three 
occasions only, being imported in each instance. Situated 
700 miles from the City of Mexico, at an altitude of 1,630 
feet, it is outside of the Yellow Fever Zone ; but railroads 
and the rapidity of modern travel may in time cause the 
^tegomyia Calapus to become a permanent denizen of the 
place, and cause Monterey to align itself with Vera Cru^ 
and other endemic foci of the Mexican Eepublic. 



730 HISTORY OF YELLOW FEYER. 

Summary of Epidemics. 

1898. 

Yellow fever broke out in ^Vlonterey during the last 

week of JuIt, and lasted until December. The cases and 
death were as follows : 

Cases. Deaths. 

To October 25 40 

Xovember 1 4 

2 11 8 

5 1 5 

6 3 

8 2 

2.5 to December 10 3 

Total 52 25 

The source of infection is !iot stated. 

1903. 

MontereT was infected by reftigees from Linares in 
Jtiiv 1903. There were about 500 cases. Xo authentic 
statistics as to the mortality could be obtained. 
1901. Sporadic cases. 

MOTUL. 

1903. One case, September 6. 

MOXTZOROXGO. 
1903. Sporadic cases in Jtily. 
XAULTA. 
1859. Sporadic cases. 



MEXICO. 731 

NICAYUCA. 

1877. Infected by San Juan. Limited outbreak. 
NUEYA LAEEDO. 

1903. September 15 to November 28: Sixty-six cases; 
29 deaths. 

1904. Sporadic cases. 

ocus. 

1895. Sporadic cases. , 

OMEALCA. 

1905. October 8 to November 4: Sixteen cases; 7 
deaths. 

OKIZABA. 

Orizaba has a population of about 25,000 and is 70 miles 
southeast of Vera Cruz. 

1883. 

Sporadic cases, imported from Vera Cruz. 

1899. 

Previous to 1899, yellow fever had never been observed 
epidemically in Orizaba. The sudden appearance of the 
disease in the year above mentioned was caused by im- 
portation, but whether from Vera Cruz, Cordova or Coat- 
zacoalcos, has not been satisfactorily determined to this 
day. The Mexican government sent a Commission to 
Orizaba, headed by Dr. Narcisso del Rio, in order to study 
the causes of the disease and ascertain whether the 
Stegomyia Calopiis existed in Orizaba, or if the im- 
munity which until that year had prevailed in that local- 
ity was due to the fact that the insects in question can 
not live there or reproduce themselves at the height at 
which the citv is located. 



732 HISTORY OF YELLOW FEVER. 

When Dr. del Eio arrived at Orizaba, he was iufcrmed 
that the first case was that of an tinknown man, who 
entered the hospital in a dying condition, where he died 
a few moments after his arrivaL The symptoms of the 
fever which had catised the death of the patient being 
very suspicious, an autopsy was made, all the character- 
istics, traces and features of yellow fever were fotmd: 
but it was not known where the unfortunate had con- 
tracted the disease, nor the place whence he came — nobody 
knew him. This case was tmdoubtedly the origin of the 
others which followed shortly afterwards, btit the medium 
of transmission from the first case to the others was never 
determined. 

At the time of Dr. del Eico's arrival, he was informed 
by the Mayor that 12 cases had already occurred in the 
town, of which 10 had died, and that there still remained 
a woman at the hospital and another convalescent patient 
in another part of the city. 

Dr. del Eio visited the woman at the hospital. She had 
been attacked four days previously, and her illness was 
an acute case of yellow fever. She had not been outside 
of the city limits, so it was clear that the infection was 
local. Two cases were also discovered in the central part 
of the city, in another district where the other cases had 
been observed. The patients were husband and wife. 
The woman recovered, btit the htisband died. 

Here vras unmistakable proof that the Yellow Fever 
Mosquito was present in Orizaba. To assure himself of 
this fact, Dr. del Rio, accompanied by Dr. Labardini, a 
member of the local Board of Health, and sanitary agents 
appointed by the Chief of Police, visited the houses where 
there had been some cases of the disease. 

In all of thse houses, the doctor found larvie of the 
Stcr/onij/iri CaJopus, and in one instance two mosqtiitoes 
of this kind entirely developed. These two mosquitoes 
furnished the explanation of the two cases which were 
noted in the central part if the city, quite distinct from 
the original focus, namely, the married couple, already 
referred to. and concerning which the following data was 
secured : 



MEXICO. 733 

The liusband was a coachman who had charge of carry- 
ing to the hospital in his carriage a sicli w^oman w^ho lived 
in the infected district, and whom he had to carry in his 
arms, because her condition was so serious that she could 
not Avalk. The room which said patient had occupied was 
disinfected by means of sprinkling bichloride of mercury, 
and it Avas in said room that was found the specimen of 
the Stegomyia Calopus entirely devoloped, it being very 
probable that the coachman was bitten there by one of 
the infected mosquitoes. 

The Commission concluded that two conclusions were 
generally acceptable, viz. : Either the first case came 
from Vera Cruz, Cordova or Coatzacoalcos, and from said 
case were infected the mosquitoes found at Orizaba, there- 
by propagating the epidemic, or the mosquitoes already 
infected at Vera Cruz Avere carried by rail to Orizaba, 
Avhere the first patient contracted the disease from the 
mosquitoes which arrived in the manner already described. 

The last theory is most acceptable and it is to be won- 
dered at that the disease has not appeared more fre- 
quently at Orizaba, OAving to the facility of communica- 
tion betAveen that city and Vera Cruz. 

Dr. del Eio does not give any statistics regarding the 
cases and deaths, but acocrding to the records of the 
United States Marine Hospital Service, the mortality was 
as follows: 

May 1 to September 30 77 

October 1 to November 8 36 

Total 113 

This was the only extensive epidemic of yelloAA^ feA^er 
which has CA^er visited Orizaba. 

1902. 

Yellow fever was imported to Orizaba in 1902, either 
from CordoA^a, Vera Cruz or Tehuantepec. It spread to 
the neighbor in.o: villas^es and lasted from the end of 
August to the beginning of November, resulting in 700 



734 HISTORY OF YELLOW FEVER. 

cases and 286 deaths. There were 18 cases in Orizaba. 
Number of deaths not given. 

An examination by the authorities revealed the fact 
that Stegomyia Calopae were found in aboundant quan- 
tities in all the localities visited by the fever. 

1903. 

From May 17 to July 6, twelve cases of yellow fever 
were observed in Orizaba. Eleven of these cases were 
traced directly to Vera Cruz. Number of deaths, if any, 
^ not stated. 

1905. 

October 9 to December 9, five cases; 1 death, 

1906. 

One case in January; death. 

PAPANTLA. 

1876. Sporadic cases. 

1895. Cases in August; imported from Vera Cruz. 

PAEAJE NUEYO, 

1907. May 1, one case; death, 

PASO DE OVIJAS. 

1876. Sporadic cases. 

PINCHUCALCO. 

1877. Infected by San Juan; limited outbreak. 

PEESIDIO. 
1883. Limited epidemic. 



MEXICO. 735 

PROGEESO. 

Progreso is an important port in the State of Yucatan, 
26 miles by rail from Merida, the Capital. It is a regular 
port of sail for American and British steamships* 

Yellow fever has never prevailed epidemically in P^ra 
greso, the few manifestations of the disease in that port 
having been as follows: 

1899. Two cases and one death in July. 

1900. June 9 to September 30: Nine deaths; number 
of cases not stated. 

1901. July 23 to October 6 : 5 cases ; 3 deaths. Two 
of these cases were from' the steamship Mathilde^ from 
Tampico via Vera Cruz. 

1902. Three cases; deaths not stated. 

1903. January 1 to November 7: Nineteen cases; 5 
deaths. 

1904. April 28 to December 8 : Sixteen cases ; 3 deaths. 
1906. August 4 to November: Sporadic cases; im- 
ported. 

PUEBLO-YEJO. 

1865. Six cases; focus of infection, Tampico. 

PUERTO ANGEL. 
1883. Infected by Mazatlan; limii\^d outbreak. 

QUANTANA ROO. 

1903. One case, September 25; death. Imported. 
1906. Sporadic cases. 

REATA. 

1903. One case, November 26; imported. 



736 HISTORY OF YELLOW FEVER. 

KEYNOSA. 

1859. The town of Eeynosa, on the Rio Grande, forty 
miles above Matamoras, suffered from yellow fever in 
1859, but beyond the statement that ^'over 130 had died," 
no further information could be obtained. 

ROSAEIO. 

1883. During the great epidemic of 1883. Eosario 
was infected by refugees from Mazatlan. Statistics in- 
complete. 

1885. A case occurred in July. 

1902. Fourteen cases; deaths not stated. 

1903. August 9 to November 28 : Twenty-three cases ; 
eleven deaths. 

1904. April 3 to June 4: Two cases; death. 

SALINA CEIJZ. 

1883. Infected by Mazatlan; limited outbreak. 
1906. March 18: One case, imported from Santa 
Lucretia. 

SAN ANTONIO. 

1877. Infected by San Juan. Limited outbreak. 

SAN BENITO. 

1883. Eefugees from Mazatlan infected San Benito 
in September, 1883. . Sporadic cases occurred until the 
beginning of November. 

SAN BLAS. 

1883. Yellow fever reached Sau Bias, the first part 
south of Mazatlan, by a small schooner carrying fleeing 
people from the larger town. A case appeared, than the 
usual explosion took place — and the disease was epidemic. 
The first case erupted September 23 ; the last in November. 



i 



MEXICO. 737 

During the epidemic, so great was the terror of the 
inhabitants, that the sick were abandoned by their rela- 
tives and died unattended. Bodies remained unburied 
for days. All those who could do so, fled to the interior, 
spreading the pestilence wherever favorable conditions 
presented themselves. As the same thing invariably hap- 
pened in every afflicted town on the Pacific Coast of 
Mexico during the outbreak of 1883, it will readily be seen 
why the epidemic became so widespread, and its progress 
so difficult to check. 

SAN FERNANDO. 

1898. Yellow fever reported present in September ; no 
statistics. 

SAN GEEOMINO. 

1902. One case; imported. 

SAN IGNACIO. 
1883. Sporadics cases; imported. 

SAN JUAN BAUTISTA. 

1876. Sporadic cases; imported. 

1877. Infected by Campeche; limited outbreak. 

1899. Sporadic cases in August. 

1902. Eight cases; imported. 

SAN LOEENZO. 
1899. Sporadic cases in August; imported. 

SAN LUIS POTOSI. 

1903. Sporadic cases in July; imported. 



738 HISTORY OF YELLOW FKVKR. 

SANTA CKUZ DE LOS EOSALES. 

1906. One case in March, imported from Santa 
Lucretia. 

SANTA LUCKETIA. 

1906. Sporadic cases; source of infection not stated. 
Several villages in the neighborhood were infected from 
this focus. 

SANTIAGO ACAPEMETA. 

1883. Infected by ref guees from Mazatlan ; limited out- 

SOCONUSCO. 

1883. Infected by refugees from Mazatlan; limited 
outbreak. 

1905. Six cases and three deaths in October ; imported. 

TAMPICO. 

Tampico is an important commercial port of eastern 
Mexico, in the State of Tamaulipas, 215 miles northwest 
of Vera Cruz, on the south shore of the Lake of Tampico. 
Population, about 12,000. It was founded by Santa 
Anna in 1823, who gave it the name of Santa Anna de 
Tamaulipas. After the downfall of Santa Anna, the 
name of the town was changed to Tampico Pueblo Nuevo, 
but it is popularly known as Tampico. 

Tampico is said by some writers to be one of the en- 
demic foci of yellow fever in Mexico, but such is not the 
case, as in nearly every instance when the disease appeared 
in the locality, it could either be traced to importantion 
or a recrudescence of a previous outbreak. 

Summary of Epidemics. 

1836. 

Although Liceaga (Am. Puh. Health Assn. Reports, 
1893, p. 123) asserts that yellow fever first appeared in 



MEXICO TAMPICO. 739 

Tampico in 1843, Goupilleau, of Tampico, in his elaborate 
work {Remarques et Observations sur la Fievre Jaime du 
Mexique), gives histories of cases as early as 1836. 
Tampico had then a population of 5,000, of which 1,250 
were Europeans and the balance native Mexicans (In- 
dians). How the fever was brought to the town, our 
authority does not state. Six cases and one death oc- 
curred in July, after which there was a lull, the epidemic 
reappearing in September. The fever was particularly 
fatal to the European population and especially to those 
who had lived for many years in Havana and other West 
Indian localities. This is one of the most remarkable 
phases of the epidemic, as the newcomers, having pre- 
viously lived within the endemic yellow fever centers, 
should have been less susceptible to the influences of th^ 
disease. Humnoldt {Political Essay on the Kingdom of 
'New Spain) comments on this pecularity as regards Vera 
Cruz, having noted that residents of Havana who settle 
in the Mexican city, and who had never experienced yel- 
low fever in their natal place, generally contract the dis- 
ease in their new abode. The same thing happens to 
natives of Vera Cruz who migrate to Havana. This proves 
that immunity is confined solely to one's native place. , 

1843. 

Yellow fever was introduced in Tampico by troops from 
Vera Cruz in 1843. The extent of the outbreak is not 
stated. 

1847. 

Troops from Vera Cruz again introduced the disease in 
1847. The war between Mexico and the United States 
was then in progress and the American soldiers who oc- 
cupied Tampico suffered greatly. 



1848. 
Vera Cruz again infected Tampico. As in the previous 
'ar, the American troops were the greatest sufferers. 



740 HISTORY or YELLOW FEVER. 

185^. 
Sporadic cases. 

1863. 

Two battalions of the French army brouglit tlie disease 
from Vera Cruz. The outbreak was not severe. 

1804. 

Infection from Vera Cruz. Xo statistics. 

1865. 

The French Army arrived at Tampico from Vera Cruz 
in xlugust. The following day yellow fever broke out 
among the soldiers and the epidemic spread through the 
town. The disease disappeared after the withdrawal of 
the troops. 

. 1878. 

New Orleans is accused of having infected Tampico in 
1878. The epidemic was extensive, about 1,000 deaths 
being recorded. 

1879. 

Xo source of infection can be traced. The fever broke 
out in June and lasted until December. The outbreak 
was not as Avidespread as in 1878. 

1898. 

The fever appeared in July and lasted until the begin- 
ning of December. Following is a resume of the mortality : 

To July 21 7 

Week ending July 31 9 

August to September 1 122 

September 2 to October 2 61 

October 3 to October 23 21 

October 21 to November 30 10 

Total mortalitv 230 



MEXICO. 741 

Number of cases not stated. 

1899. April 20 to October 2: Seventeen cases; three 
deaths. 

1901. July 26 to August 22 : Two cases ; one death. 
One case imported from Progreso; the other from Vera 
Cruz. 

1902. Mortality : November, 52 ; December, 60 ; total, 
112. 

1903. Mortality : January, 10. Subsidence until May, 
when the disease again made its appearance and lasted 
until October. Last death, October 24. Total deaths, 
259. 

1904. 

First case was observed in the beginning of May. Four 
cases are recorded for the year. 

TAMUIN. 

1903. Sporadic cases in August; imported. 

TAPACHULA. 

1883. Infected by Mazatlan; limited outbreak, 
1895. Sporadib cases; imported. 

TEPEC. 

1883. Limited outbreak; imported. 

TEHUANTEPEC. 

1883. Tehuantepec has 12,000 inhabitants and is one 
of the oldest toAvns in Mexico. It certainly is dilapidated 
looking, and its antiquity is undoubted, but considering 
that it has survived w^ars, floods and earthquakes innum- 
erable, and has lived through epidemics of cholera, small- 
pox, beriberi and yellow fever, it is really w^onderful that 
it is still in existence. 



f42 



HISTORY OF YELLOW FEVER. 



Teliuantepec is situated on the river bearing the same 
name about 12 miles from the Pacific Ocean, and is built 
of adobe and cane houses with tiled and thatched roofs. 
It is clustered on the hillside, and is naturally well 
drained. It was built without regard to street formation 
and before sewers and waterworks were known. The 
water supply is obtained from a few wells, but the major- 
ity of the inhabitants bring their water from the river in 
jars and barrels. The majority of the population are 
women, and with the exception of a few foreigners and 
some Mexicans, the population is composed of Tehuan- 
tepec Indians. 

In December, 1882, an epidemic of Asiatic cholera oc- 
curred, and by March of the following year 297 deaths 
were recorded. An epidemic of yellow fever followed the 
cholera, and when it ended, the town was about depopu- 
lated. From an old resident who lived through both epi- 
demies it was learned that the mortality statistics were 
not kept at the time, and that the mortality in Tehuan- 
tepec and vicinity must have been in the thousands, judg- 
ing from the information that he received at the time. 

1899. Sporadic cases. 

1900. Scattered cases. 

1902. Eight cases. 

1903. August 9 to November 28 : Ten deaths. 

1904. January 1 to December 17 : Sixty-six cases ; 53 
deaths. 

1905. June 24 to December 2 : Five case ; 2 deaths. 

1906. Infected by Santa Lucretia in March; sporadic 
cases. 

TEKAN. 

1903. Sporadic cases in August. 

TEXISTOPEC. 

1904. Scattered cases; imported. 



MEXICO. 743 

TEZONAPA. 

1905. October 1 to December 9: Twelve cases; 4 
deaths. 

TIEEEA BLANOA. 

1903. Sporadic cases in July; imported. 

1906. October 22 to November 18: Eight cases: 2 
deaths. 

1906. August 11 to September 22: Two cases; 1 
death. Imported from' Santa Lucretia. 

TAPONA. 

1899. Sporadic cases; imported. 

1900. One case ; imported. 

TLACOLTIPAN. 

1877. Sporadic cases; imported. 

1883. Limited outbreak; cases imported. 

TPISLAN. 

1853. Infected by Acapulco; limited outbreak. 

TONALA. 

1883. Infected by Mazatlan; limited outbreak. 
1902. One imported case. 

TUXPAN. 

Tuxpan is situated on the north bank of the Tuxpan 
River, about seven miles from its mouth, one hundred 
and ten miles north of Vera Cruz, and about the same dis- 
tance south of Tampico. The town is only about fifteen 
feet above the sea level of the Gulf, and has a population 
of 12,000. 



744 



HISTORY OF YELLOW FEVER. 

Summary of Epidemics. 



The French 



Mild epidemic. 

Infected by troops from Vera Cruz; mild out- 



1838. Sporadic cases; imported. 

1863. Infected hj troops from Vera Cruz. 
Army suffered greatly from the disease. 

1873. Severe epidemic; no details. 

1875. Infected by troops from Vera Cruz ; limited out- 
break. 

1877. 

1878. 
break. 

1880. Infected by Tampico ; limited outbreak, being 
contined to imported cases. 

1892. A traveler arrived at Tuxpan from Papantla on 
August 10. He was taken ill shortly afterward and died 
of yellow fever. There was no spread of the disease. 

1899. July 30 to November 8, sixty-nine deaths. 

1902. One case, from Vera Cruz. 

1907. One case, January 23; death. Imported. 



1877. 

1905. 
deaths. 

1906. 
deaths. 



1901. 
1903. 
1906. 
death. 



TUXTEPEC. 

Infected by Tlacotalpan; limited outbreak. 
October 8 to December 9 : Thirty-two cases ; 21 

August 26 to October 6: Seventeen cases; 13 
VALLADOLID. 

September 25-28 : Four deaths. 

August 9 to September 26 : Sporadic cases. 

August 25 to September 1: Three cases; one 

VEKA CRUZ. 



Vera Cruz, the chief seaport of Mexico, is situated on 
the Gulf of Mexico, in a sandy, marshy, unhealthy place, 
185 miles east of Mexico City. The fact that after four 
hundred years of strenuous existence. Vera Cruz is a city 



MEXICO VERA CRUZ. 745 

of only 32,000 inhabitants, notwithstanding its command- 
ing position on the great American Inland Sea, is suffici- 
ent proof of the unfitness of the locality as a place of 
abode for the average human being. Although founded 
by Cortez in 1520, the site of the City of Vera Cruz was 
occupied by the Spaniards as early as 1509, during which 
year the unfortunate settlers were decimated by the first 
epidemic of yellow fever to attack Europeans on Conti- 
nental America. 

Yellow fever has prevailed in Vera Cruz almost every 
year since its occupation by the Spaniards, and the place 
may be unhesitatingly considered as one of the most 
fruitions foci in America. Even at the time this report 
is being prepared for the printer (April 8, 1909), the 
disease has attained epidemiological proportions in the 
insalubrious Mexican city — and this, too, in the face of 
the fact that everybody in Vera Cruz ought to have had 
yellow fever by this time. But strangers are constantly 
arriving — especially native Indians from the interior — 
feeding the fires of pestilence, and finding untimely 
sepulture in that unfriendly soil. And thus will it be un- 
til time is no more— unless the Mosquito Doctrine 
triumphs over indolence and stubbornness, and removes 
the only stumbling block to the future greatness of the 
^^rich city of the true cross."* 

CHEONOLOGY OF YELLOW FEVEE IN VEEA CEUZ 

FOE A PEEIOD OF FOUE HUNDEED YEAES, 

1509 TO 1909. 

1509. According to Parker, Beyer and Pothier (Report 
of Working Party Vo. 1^ Yellow Fever Institute, M^asli- 
ington, D. C, 1903), the earliest record that can be found 
showing the presence of yellow fever in Vera Cruz was 
in 1509, when Diego de Nicues occupied the place, then 
called New Spain. During the first days of the colony, 400 
of the settlers died from a "pestilential disease;" shortly 
afterward, 200 more. At the end of fifteen months, there 



746 HISTORY OF YELLOW FEVER. 

remained odIj 60 survivors. From descriptions given by 
early writers, there can be no doubt that this was yellow 
fever. 

1510 to 1698. A search through the works of his- 
torians who have written on the epidemics of Mexico, 
fails to reveal any authentic reference regarding the ap- 
pearance of yellow fever in Vera Cruz from 1510 to 1698. 
The disease was undoubtedly present, as, even to this day, 
the infection is kept virulent and constant by the presence 
of native Indians, who came from the mountains and 
adjoining villages. Parker, Pothier and Beyer {loc. cit.) 
state that while many foreigners and the better class of 
Mexicans from the tierras templadas die annually of yel- 
low fever in Vera Cruz, it is the unacclimated natives 
above mentioned who come from the mountains to work 
on the harbor improvements or to sell their wares that 
makes the death-rate of Vera Cruz excessive. 

The Indians certainly came to Vera Cruz during the 
silent years above noted, and it is the natural inference 
to conclude that they died of yellow fever, just as their 
descendants do at the present age. 

1699. First appearance of yellow fever in Vera Cruz, 
according to Berenger-Feraud (Fievre Jmrne, etc., Paris, 
1890, p. 37). No details. 

1700 to 1724. Another hiatus. 

1725. Most authors date the first appearance of yellow 
fever in Vera Cruz from 1725, prominent among whom 
being the Abbe Clavigero, historian of note, who mentions 
the fact in his History of Mexico. But Humboldt, Ber- 
enger-Feraud and other well-posted chroniclers, assert 
that the eminent ecclesiastic is mistaken, for, long before 
the Seventeenth Century, the pestilential disease known 
as vomito prieto by the Spaniards, showed itself many 
times in the locality. No records are available, however, 
tradition and unofficial documents being the only beacons 
to guide us through the darkness of that period. 

1726 to 1739. Present, but no record. 

1740. Severe epidemic. (Berenger-Feraud). 

1741 to 1743. Present, but no record. 



MEXICO VERA CRUZ. 7*7 

1744. Severe epidemic. (Feraud). 
1745 to 1761. Present, but no record. 

1762. Severe epidemic. {Humboldt; Moreau de 
Jonnes). 

1763. No record. 

1764. Epidemic. 

1765 to 1773. No record. 

1774. Epidemic. 

1775 to 1792. No record. 

1793; 1794; 1795; 1796; 1797; 1798; 1799; 1800; 1801; 
1802; 1803; 1804; 1805. Epidemics of more or less 
intensity. 

1806 to 1808. No record. 

1809 ; 1810 ; 1811 ; 1812 ; 1813. Epidemics of more or 
less intensity. 

1814. No record. 

1815. Epidemic. 

1816. No record. 

1817; 1818; 1819. Epidemic period. 

1820. No record. 

1821; 1822; 1823. Epidemic period. 

1824. No record. 

1825; 1826; 1827; 1828. Epidemic period. 

1828. No record. 

1829. Epidemic. 

1830. No record. 

1831. Epidemic. 

1832 to 1835. No record. 

1836; 1837. Epidemic. 

1838. No record. 

1840 ; 1841 ; 1842. Epidemic. 

1843. No record. 

1844; 1845; 1846; 1847. Epidemic. 

1848 to 1849. No record. 

1850. Epidemic. 

1851 to 1852. No record. 

1853; 1854. Epidemic. 

1855 to 1856. No record. 

1857. Epidemic. 



748 



HISTORY OF YELLOW FEVER. 



1858. No record. 

1859 ; 1860. Epidemic. 

1861. No record. 

1862 ; 1863 ; 1861 ; 1865. Epidemic 

From 1866 to the present day, more definite information 
CO aid be obtained, the mortality by months from 1866 to 
1900 being- as follows: 



Months. 



Years. 



1867.. 
1868.. 
1869.. 
1870.. 
1871.. 
1872.. 
1873.. 
1874.. 
1875.. 
1876. 
1877 
1878. 
1879. 
1880. 
1881. 
1882. 



1884., 
1885., 
1886, 
1887.. 
1888., 
1889., 
189a 
1891. 
1892., 
1893., 
1894. 
1895. 
1896.. 
1897. 
1898. 
1899.. 



Total 















































ci p 


PA 


;- 










. 


^ 




£ 


^ 


<s ^ 


:; 


Z, 


£ 
u 


t i 


V 


.; 
■^ 


3 
fcfi 


a 

a 


s 


1 

> 

O 


a 


" _ u 







1^ 
2 


< 
11 


e5 


"-i 


^ - 


i 


» 


12 


21 


20 


H 





26 


40 


54 


48 


20 


254 


IS 


4 


16 


54 1 64 


42 


8 


32 


38 


17 


11 


8 


212 


7 


6 


t 


30 ' 40 


16 


26 


20 


21 


9 


2 


3 


187 











2 j 





1 


1 


2 


1 


2 





9 





(1 

















1 


3 


5 


2 


11 


3 





1 


6 i 29 


113 


71 


17 


10 


15 


2 


4 


271 


2 


2 


4 


5 ; 14 


45 


53 


39 


29 


11 


5. 


6 


215 


1 








3 ! 1 


19 


58 


59 


4t 


20 


10 


7 


222 


1 


2 





2 


3 


11 


24 


7 


12 


u 


6 


79 


7 


o 


4 


11 


29 


93 


118 


105 


41 


13 


2 





425 





1 


1 








2 


4 


7 


9 


6 


1 


3 


34 





1 








4 


7 


54 


144 


164 


77 


50 


27 


528 


16 


5 





I 


7 


58 


113 


110 


02 


45 


24 


7 


448 


6 


4 


2 


■1 


1 


1 


2 


1 


3 











21 


2 





1 











T 


3 


10 


42 


92 


103 


254 


2S 


21 


27 


29 


94 


235 


18 J 


39 


22 


25 


17 


3 


723 


1 


1 


2 


1 


5 


11 


7 


14 


8 


3 


5 


12 


72 


5 


3 


7 


16 


90 


261 


200 


67 


39 


31 


21 


7 


747 


3 


2 








3 


2 


4 


3 


17 


44 


39 


19 


136 


6 


5 


8 


5 


21 


25 


84 


84 


48 


19 


14 


9 


328 


7 


3 


7 


12 


is 


31 


19 


26 


25 


37 


13 


10 


208 








1 








1 








1 


1 








4 


























1 


2 








3 











1 




















1 





2 

















1 


1 


5 





6 


9 


19 


41 


1 


4 


2 


3 


10 


39 


40 


19 


13 


18 


20 


10 


. 179 





o 


1 


7 


20 


41 


75 


53 


27 


13 


10 


10 


260 


5 


1 


6 


8 


17 


32 


29 


8 


9 


11 


5 





131 











8 


39 


55 


44 


38 


15 


5 


3 


3 


210 


5 


1 


1 


2 


12 


23 


40 


36 


17 


3 


3 





143 















































-t) 




















1 


1 





2 























9 


2t 


39 


32 


23 


127 


9 


5 


7 


8 :ioi 


246 


90 


68 


31 


14 


5 


7 


670 


133 


75 


,0T 


•224 


647 


1,442 


1,390 


1,079 


759 


557 


436 


328 


7,156 



1900. No yellow feyer. 

1901. Epidemic ; 102 deaths. 

1902. Seyere epidemic : 721 cases ; 274 deaths. 

1903. Seyere epidemic: January to December, 1,123 
cases ; 357 deaths. 

1904. Only one death. 

1905. Sporadic cases ; 10 deaths. 



MEXICO. 749 

1906. January 1 to December 8: Twenty-one cases; 
10 deaths. Three of these cases were imported from 
Yucatan and 7 from Quintana. 

1907. February 9 to March 22: Two cases; 1 death. 
One case was imported from Paraje Nuevo. One new 
case, September 1. Total : Cases, 3 ; deaths, 1. 

1908. July 7 to December 5: Thirty-four cases; 18 
deaths. 

1909. Epidemic. 

VICTOKIA. 

Victoria, or Nueya Santander, is the capital of the 
State of Tamaulipas, 120 miles northwest of Tampico. 
It has suffered very little from yellow fever. The few 
instances were as follows : 

1899. Sporadic cases in October ; imported. 

1903. Three cases and one death in Aup^ust ; imported. 

1904. Infected by Tampico. December 6 to 19 : 
Four cases; tw^o deaths. 

XUMPICH. 

1908. November 1 to November 30: Two cases; 
imported. 

YUKI. 

1883. Yuki, in Sonora, near the Arizona border, was 
invaded for the first and only time by yellow fever during 
the epidemic of 1883. The mortality is said to have been 
heavy, considering the smallness of the place, but no 
statistics were kept. 

ZONGOLICA. 

1903. Five cases in July; imported. 

ZUCATULA. 

1883. Zucatula, on the Pacific coast, suffered from yel- 
low fever for the first and only time in 1883. No statistics 
are available. 



750 HIITORY or YILLOW FEVER. 

BIBLIOGRAPHY OF YELLOW FEVER IN MEXICO. 

ACAPULCO. 

Humboldt: Report Sanitary Commission of New Orleans, 1853, p. 126 

Main: Medical News, New York, 18S3, vol. 43, pp. 419, 556, 671, 699. 

Ibid., 1884, vol. 44, pp. 44, 55. 

Liceaga: Trans. Am. Pub. Healtb Association, 1SS3, vol. 19, p. 120. 

Ibid, 1896, vol. 21, p. 166. 

Ibid, 1897, vol. 22, p. 165. 

U. S. Public Health Reports, 1887, p. 69. 

U. S. Public Health Reports, 1895, vol. 10, p. 1147. 

Ibid., 1896, voL 11, p. 1200. 

ACAYUGA. 

Liceaga: Trans. Am. Pub. Health Assn., 1902, vol. 28, p. 258. 

ALTATA. 

Main: Medical News, 1SS3, vol. 43, pp. 475, 556. 

Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, p. 128. 

ALTAMERA. 

Gk»urgues: Journal de Medecine de Paris, 1883, vol. 5, p. 228. 
Liceaga: Trans. A, P. H. Assn., 1893, vol. 19, pp. 125, 126. 
U. S. Public Health Reports, 1903, vol. 18, p. 2309. 

ALVARADO. 

Liceaga: Trans. A. P. H. Assn., 1902, vol. 2S, p. 258. 
r. S. Public Health Reports, 1SS9, p. 2367. 

ATAI. 

Main: Medical Xew3, 1S93, vol. 43, p. 529. 

CAMARGO. 

U. S. Public Health Repoics, 1883, pp. 327, 328. 

CAMPECHE. 

Liceaga: Trans. U. P. H. Assn., 1SS3, vol. 19, p. 124. 
Medical Record: 1SS3, vol. 24, p. 322. 



MEXICO. 751 

CARDENAS. 

Liceaga: Trans. A. P. H. Assn., 1893, vol. 19, pp. 125, 127. 
U. S. Public Health Reports, 1903, vol. 18, p. 2309. 

CHILPANZIGO. 

Humboldt: Report Sanitary Commission N. O., 1853, p. 127. 
U. S. Public Health Reports, 1890, p. 2367. 

CITAS. 

U. S. Public Health Reports, 1903, vol. 18, p. 2309. 

CINCHAPA. 

U. S. Public Health Reports, 1899, p.. 2366. 

COATZACOALCOS. 

Covananos: Trans. A. P. H. Assn., 1893, vol. 19, p. 105. 

Liceaga: Ibid., 1893, pp. 125,^ 127. 

Ibid., 1904, vol. 28, p. 258. 

Ibid., 1905, vol. 30, p. 214. 

U. S. Public Health Reports, 1903, vol. 18, p. 2309. 

Ibid., 1905, p. 2770. 

COLINA. 

Mahlo: Ann. Report Sup. S-G., 1884, p. 265. 

CORACO. 

Main: Medical News, 1883, vol. 43, p. 501. 

CONCORDIA.. 

Main: Medical News, 1883, vol. 43, p.p. 419, 501. 

CORDOVA. 

Liceaga: Trans. A. P. H. Assn., 1893, vol. 19, p. 126. 

Ibid., 1902, vol. 28, p. 258. 

Berenger-Feraud: p. 151. 

Liceaga: Journal Am.. P. H. Assn., 1897, vol. 22, p. 165. 

U. S. Public Health Reports, 1900, vol. 15, p. 815. 

Ibid., 1905, p. 2770. 



752 HISTORY OF YELLOW EEYER. 

Ibid., 1906, vol. 21, p. 741. 

Mendizabal (G.) : Contribution to the study of yellow fever in rela- 
tion to epidemics in Cordova. Am. Pub. Health, Assn. Rep., 1896, 
Concord, 1897, 22, 167. 

COSMALOAPAX. 

U. S. Public Health Reports, 1899, p. 2366. 

Liceaga: Trans. Am. Pub. Health Assn., 1902, vol. 28, p. 258. 

COS ALA. 

Liceaga: Jl. Am. Pub. Health Assn., 1883, vol. 20, p. 228. 

CULIACAX. 

Main: Medical News, 1883, vol. 43, pp. 501, 529. 
Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, pp. 126, 120. 
Preslow (I.) : Apuntes sobre la Fiebre Amarilla, que reino en Culia- 
can, desde Agosto ultimo hasta enero 15 del corriente anno. 8°. 

Culiacan, 1884. 

DOFL\ CECILIA. 

U. S. Public Health Reports, 1903, vol. 18, p. 2309. 

EL HICO. 

U. S. Public Health Reports, 1903, vol. 18, p. 2309. 

EQUADOR. 

Humboldt: Report Sanitary Commission, 1853, p. 127. 

FRO XT ERA. 

Liceaga: Journal Am, Pub. Health Assn., vol. 21, p. 165. 
Liceaga: Trans. Am. Pub. Health Assn., 1902, vol. 28, p. 258. 

GUILLICAX. 

Main: Medical Xews, 1883, vol. 43, p. 501. 

GUAYMAS. 

Main: Medical Xews, 1883, vol. 43, pp. 336; 419; 475; 529; 530; 566. 
Eighth Biennial Report Cal. Board of Health, 1884, vol. 6, p. 231. 
Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, pp. 126, 128. 



MEXICO. 753 

U. S. Public Health Reports, 1891, vol. 6, p. 370. ^ " ' 

Ibid., 1895, vol. 10, p. 1147, 

(Mix (A. A.) : The Mexican Epidemic of 1883, as it Appeared in 
Guaymas. Pacific, Med. & Surg. Jl., San Fran., 1883-4, vol. 26, p. 241. 

Pesqueira (E.) : Noticia Sinoptica de una Epidemia de Fiebre 
Amarilla en la Capital de Sonora (Gruaymas). Voz de Hipocrates, 
Mexico, 1883, vol. 1, p. 313. 

Yellow Fever in Sonora (Guaymas). Pacific Med. & Surg. Jl., San. 
Fran., 1884-5, vol. 27, p. 118. 

GUERRERA. 

Annual Report S.-G., 1883, p. 286. 

GUICHICORE. 
Liceaga: Trans. Am. Pub. Health Assn., 1902, vol. 28, p. 258. 

HERMOSILLO. 

Main: Medical News, 1883, vol. 43, pp. 419, 475, 529, 556; 1884, p. 
44, 45. 
■Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, pp. 126, 129. 

HIDALGO. 
U. S. Public Health Reports, vol. 99, p. 2667. 

HUACHIRARCO. 

Liceaga: Trans. Am. Pub. Health Assn., 1893, p. 125. 

HUIMOGUILLO. 

Liceaga: Trans. Am. Pub. Health Assn., 1893, pp. 125, 127. 

IXCALLAN. 

(Medical News: 1883, vol. 43, p. 529. 

JALAPA. 

Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, p. 127. 
Ibid., 1902, vol. 28, p. 258. 

JICALTEPEC. 

Gourgues: Journal de Medecine de Paris, 1883, vol. 5, p. 232. 
Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, pp. 123, 125, 127. 



75 i HISTORY OF YELLOW FEVER. 

JICO. 
Gourgues: Journal de Medecine de Paris, 1SS3, Yol. 5, p. 231. 

JIMIXEZ. 
U. S. Public Health Reports, 1898. 

JULTIPAX. 
Liceaga: Am. Pub. Healtb Assn., 1905, toI. 33, p. 214. 

LAGUXA DEL CARMEN. 

Ann. Rep S.-C, 1894, p. 293. 

Liceaga: Trans. Am. Pub. Health Assn., 1902, yoI. 28, p. 258. 

LAGUXA DE TERMINOS. 

U. S. Public Healtb Reports, 190S, vol. 23, pp. 759, 79S, SS9, 933. 

LA JUXTA. 

U. S, Public Healtb Reports, 1899, p. 1404. . . 

LAMPAXSAS. 

U. S. Public Healtb Reports, 1904, vol. 19, p. 2690. 

Liceaga: Trans. Am. Pub. Healtb Assn., 1905, vol. 30, p. 214, 

LA PAZ. 

Main: Medical News, 1883, vol. 43, pp. 501, 529, 530, 556. 
Eigbtb Biennial Report State Board Healtb Cal., 18S4-6, p. 230. 
Liceaga: Trans. Am. Pub. Healtb Assn., 1S93, vol. 19, p. 128. 

LOS AXIMOS. 
Liceaga: Trans. Am. Pub. Healtb Assn., 1893, vol. 19, p. 126. 

LIXARES. 

U. S. Public Healtb Reports, 1903. vol. 18, p. 2309. 

Liceaga: Trans. Am. Pub. Healtb Assn., 1905, vol. 30, p. 214. 

MAXZAXILLO. 

Mablo: Ann. Rep. Sup. Surgeon General (U. S.), 1SS4, p. 265. 
Liceaga: Trans. Am. Pub. Healtb Assn., 1893, vol. 19, pp, 126, 128. 
Ibid., 1902, vol. 28, p. 258. 



MEXICO. 755 

Main: Medkal News, 1883, vol. 43, pp. 501, 529, 671, 699. 
Ibid., 1884, pp. 44, 45., 

Liceaga: Journal Am. Pub. Health Assn., 1897, vol. 22, p. 165. 
U. S. Public Health Reports, 1907, vol. 22, pp. 1295, 1038. 

MATAMORAS. . 

Berenger-Feraud, pp. 134, 184. 

Caraza (R.) : Contribucion al Estudio de la G-eografia Medica de la 
Bepublica Mexicana; Epidemia de Fiebre Amarilla en Matamoras el 
anno de 1882.. Gac. de Hosp. Mil., Guadalajara, 1885-6, i, no.4, 3; no. 5, 
3; no. 8, 1. 

Lafon: Journal de Medecine de Paris, 1883, vol. 5, p. 228. 

Lafon (Antonio) : Report of the Yellow Fever in the City of Mata 
moras, from September, 1853, to January 1854. See Report of the 
Sanitary Commission of New Orleans, 1854. 

Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, pp. 125, 126. 

MAZATLAN. 

Eighth Biennial Report State Board Health Cal., 1884, vol. 6, p. 230. 
Main: Medical News, 1883, vol. 43, pp. 336, 419, 501, 529, 530, 556. 
OLiceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, pp. 126, 128. 
Ibid., 1905, vol. 30, p. 214. 

U. S.. Public Health Reports, 1895, vol. 10, p. 1147. 
Ibid., 1897, p. 1434. 

McHatton (N. H.) : Epidemic at Mazatlan. San Francisco West. 
Lancet, 1884, vol. 13, p. 112. 

MATZRORGO. 

U. S. Public Health Reports, 1903, vol., 18, p. 2309. 

MERIDA. 

National Board of Health Bulletin, vol. 1, 1879-80, p. 288. 

U.S. Public Health Reports: 1887, pp. 112, 129, 141, 166. 

Ibid., 1888, p. 31. 

Ibid., 1892, pp. 263, 285, 322. 

Ibid., 1895, p. 1572. 

Ibid., 1900, p. 3176. 

Ibid., 1901, p. 1504. 

Ibid.., 1902, p. 3880. 

Ibid., 1903, p. 2309. 

Ibid., 1905, p. 2770. 



756 HISTORY OF YELLOW FEVER. 

Ibid., 1906, vol. 21, pp. 363, 455, 557, 625, 661, 764, 788, 925, 961, 994, 
1054, 1110, 1195, 1300, 1336. 
Ibid., 1907, pp. 65, 905. 
Ibid.., 1908, p. 1894. 
Ibid., 1909 (see tables). 
Ann. Rep. Sur.-Gen., U. S., 1894, p. 293. 
Liceaga: Journal Am. Pub. Health Assn., vol. 21, p. 165. 

MEXICO CITY. 

Medical News: 1883, vol. 43, p. 363. 

U. S. Public Health Reports, 1898, p. 1422. 

Annual Report Supervising Suregon-General, 1899, p. 394. 

U. S. Public Health Reports, 1900, p. 3176. 

Ibid., 1903, vol. 18, pp. 1037, 2309. 

Ibid., 1905, p. 2770. 

MICALTEPEC. 

Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, p. 125, 127. 

MIER. 

U. S. Public Health Reports, 1883, pp. 286, 283. 

MINATILLAN. 

Liceaga: Trans. Am. Pub, Health Assn., 1893, vol. 19, pp. 125, 127. 

MISANTLA. 

Gourgues: Journal de Medecine de Paris, 1883, vol. 5, P. 232. 
Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, p.. 125; 

MONCLOVA. 

U. S. Public Health Reports, 1903, vol. 18, p. 2309. 
Liceaga: Trans. Am. Pub. Health Asm., 1905, pp. 30, 214. 

MONTEREY. 

U. S. Public Health Reports, 1898. 

Ibid., 1903, vol. 18, p. 2309. 

Liceaga: Trans. Am. Pub. Health Assn., 1905, vol. 30, p. 214. 

Martinez (A.) : Relacion de la epidemia de fiebre amarilla, desar- 
rollada en Monterey en Octubre y Noviembre de 1898. Gac. med 
Mexico, 1899, xxxvi 271-284. 



MEXICO. 757 

MOTUL. 

U. S. Public Health Reports, 1903, vol. 18, p. 2309. 

NAULTA. 

Gourgues: Journal de Medecine de Paris, 1883, vol. 5, p. 232. 
Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, pp. 125, 127. 

NICAYUCA. 

Trans. A. P. H. A., 1893, vol. 19, pp. 125, 127. 

■NEUVA LAREDO. 

U. S. Public Health Reports, 1903, vol. 18, p. 2309. 

Liceaga: Trans. Am. Pub. Health Reports, 1905, vol. 30, p. 214. 

OCUS. 

U. S.. Public Health Reports, 1895, vol. 10, p. 612. 

OMEALCA. 
U. S. Public Health Reports, 1905. 

ORIZABA. 

Main: Medical News, 1883, vol. 43, p. 699. 

Del Rio (N.):Reports on the Orizaba (Mexico) Epidemics. Trans, 
American Pub. Health Assn., 1905, vol. 28, p. 262. 

Kermorgant (A.) : Su.r une Epidemie de Fievre Jaune qui a Regne 
a Orizaba (Mexique). — Ann. d'Hyg. et de Med. Coloniales, 1904, vol. 6, 
p. 423. p. 423. 

Mendizabal (G.) : La segunda epidemia de fiebre amarilla en 
Orizaba. Gac. Med. Mexico, 1903, 2. s., vol. 3, p. 233. 

Schoenfeld: Annales d'Hygiene et de Medecine Coloniales, 1903, vol. 
6, p. 423. 

Liceaga: Trans. Am. Pub. Health As3n., 1902, vol. 28, p. 258. 

U. S. Public Health Reports, 1899, p. 2365. 

Ibid., 1905, vol. 21, p. 742. 

Ibid., 1906, p. 741. 

Yellow Fever at Orizaba in September, 1902, transmission by 
mosquitoes. Pub Health Rep. U. S. Mar. Hosp. Serv., Wash., 1903, 
vol.. 18, p. 224. 



758 HISTORY or yellow fevbr. 

PAPANTLA. 

Gourgues: Journal de Medecine de Paris, 1883, vol. 5, p. 232. 
Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, pp. ]25, 127. 
Liceaga: Journal Am. Pub. Health Assn., 1895, vol. — , p. 228 
(History,.) 
Ibid., Journal Am. Pub. Health Assn., 1897, vol. 22, p. 163. 

PARAJE NUEVO. 

U. S. Public Health Reports, 1907, \ol. 22, pp. 405, 905. 

PASO DE OVIJAS. 

Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, p. 126. 

PINCHUCALCO. 

Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, pp. 125, 127. 
(History). 

PRESIDIO. 

Main: Medical News, 1883, vol. 43, p. 501. 

Hargrave (E. J.) : Report of my own case of yellow fever, in Pro- 
gress, Yucatan. Charlotte (N. C.) Med,, Jl., 1903, vol. 22, p. 4. 

PROORESO. 

U. S. Public Health Reports, 1900, pp. 1682, 3177. 

Ibid., 1901, p., 3084. 

Ibid., 1903, p. 2310. 

Ibid., 1909, pp. 1304, 2690. 

Trans. Am. Pub. Health Assn., 1902, vcl. 28, p. 258. 

PUEBLA. 

Trans. Am. Pub. Health Assn., 1893. 

PUEBLO VEJO. 

Jaspard: Archives de Medecine Nav. 1, 1854, vol. 2, p. 111. 
Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, p. 128. 

QUINTANA ROO. 

TJ. S. Public Health Reports, 1906, vol. 21, p. 742. 



MEXICO. 759 

RE AT A. 

U. S. Public Health Reports, 1903, vol. 18, p. 2310. 

REYNOSA. 

N. O. Med. & Surg. Journal, 1859, vol. 16, p. 752. 
Annual Report Sur.-Gen. U.. S., 1883, p. 327. 

ROSARIO. . 
Eighth Biennial Report California Board Health, 1884-6, p. 230. 

SALINA CRUZ. 

Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, p. 128. 

Ibid., 1902, vol. 28, p. 258. 

tbid., 1905, vol., 30, p. 214. 

U. S. Public Health Report, 1903, vol., 18, p. 2310. 

[bid., 1904, vol. 19, p. 1304. 

Ibid., 1906, vol. 21, p. 742. 

SAN ANTONIO. 

iLiceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, pp. 125, 127. 

SAN BONITO. 

Eighth Biennial Report California Board Health, 1884-6, p. 231. 
Liceaga: Trans. Am. Pub. Health Assn., 1903, vol. 19, p. 129. 

SAN BLAS. 

iMain: Medical News, 1883, vol. 43, p. 419. 

Liceaga: Trans. Am. Pub. Health Assn., 1893, vol 19, pp. 126, 128. 

SAN FERNANDO. 
U. S. Public Health Reports, 1898, p. 1116. 

SAN GERONIMO. 
Liceaga: Am. Pub. Health Assn., 1902, vol. 28, p. 258. 

SAN IGNACIO. 
Liceaga: Journal Am. Pub. Health Assn., 1895, vol. 20, p. 228. 



760 HISTORY OF YELLOW FBVKR. 

SAN JUAN. 

Liceaga: Trans. Am. Pub. Healtli Assn., 1893, vol. 19, pp. 125, 126, 127. 

U. S. Public Health Reports, 1899, p. 2366. 

Ibid., Trans.. Am. Pub. Health Assn., 1902, vol. 28, p. 258. 

SAN LUIS POTOSI. 

U. S. Public Health Reports, 1903. vol. 18, p.. 2310. 

SANTA CRUZ. 

U. S. Public Health Reports, vol. 21, pp. 741, 961, 1027. 

SANTA LUCRETIA. 

U. S. Public Health Reports, 1906, vol. 21, p. 742. 

SANTIAGO ACAPONETA. 

iMain: Medical Record, 1883, vol. 43, p. 529. 

Liceaga: Trans. Am. Pub. Health Assn., 1893, vol, 19, p. 128. 

SOCONUSCO. 

Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, p. 128. 
U. S. Public Health Reports, 1905, p.. 2770. 

TALLERES. 

U. S. Public Health Reports, vol. 19, p. 1304. 

TABASCO. 

Castaneres (A.) : A few general remarks regarding yellow fever in 
the State of Tabasco. Am. Pub. Health Assn. Rep. 1892, concord, 
1893, vol. 18, p. 217.. 

TAMPICO. 

Goupilleau: Remarques et Observations sur la Fievre Jaune du 
Mexique. In Bull, de 1' Acad, de Medecine Paris, 1838, vol. 3, p. 305. 

Liceaga: Am. Pub. Health Assn., 1893, vol. 19, pp. 123, 126, 127. 

Ibid., 1902, vol. 28, p„ 258. 

Gourgues: Journal de Medecine de Paris, p. 230. 

Berenger-F-' ^ud, p. 140. 

Jaspard ( P. H.) : Trois mois de fievre jaune a Tampico; considera- 
tions Theoriques et pratiques. 4°. Montpellier, 1865. 



MEXICO. 761 

Jaspard: Archives de Medecine Nav. raris, 1864, vol. 2, p. 109. 

Cassard: National Board Health Bulletin, 1879-80, vol. 1, p, 149. 

U. S. Public Health Reports, 1899, pp. 1011, 2367. 

Ibid., 1901, p. 3084. 

Ibid., 1903, p. 2310. 

Ibid., 1904, p. 2690. 

Kermorgant (A.): Notes sur la fievre jaune a Tampico. Ann. d'Hyg. 
et de Med. Colon., Par., 1904, vol. 7, p. 534. 

Epidemiologie: Particularites d'etiologie et de marche presentees 
par I'epidemie de fievre jaune qui a sevi a Tampico sur le 2e regiment 
d'infanteTie de marine. Arch, de med nav., Par., 1864, vol. 2, p. 109. 

TAMUIN. 

U. S. Public Health Reports, 1903, vol. 18, p. 2310. 

TAPACHULA. 

Liceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, p. 129. 
U. S. Public Health Reports, 1895, vol. 10, p. 612. 

TAPONA. 

U. S. Public Health Reports, 1899, p. 2367.. 

Liceaga: Trans. Am. Pub. Health Assn., 1902, vol. 28, p. 258. 

TEPEC. 

Main: Medical News, 1883, vol. 43, p. 529. 

TEHUANTEPEC. 

U. S. Public Health Reports, 1900, p. 1520. 

Ibid., 1899, p. 1039. 

Ibid., 1900, p. 1517. 

Ibid., 1903, p. 2310. 

Ibid., 1904, p. 2690. 

Lriceaga: Am, Pub. Health Assn., 1902, vol. 28, p. 258. 

Ibid., 1905, p. 2770. 

Ibid., 1906, vol. 21, p. 742. 

TERAN. 
U. S. Public Health Reports, 1903, vol. 18, p. 2310. 

TEXISTEPEC. 
Liceaga: Trans.. Am. Pub. Health Assn., 1905, vol. 30, p. 215. 



762 HISTORY OF YELLOW FEVER. 

TEZONAPA. 

V. S. Public Health Reports, 1905, p. 2770. 

TIERRA BLANCA. 

U. S. Public Health Reports, 1903, vol. 18, pp. 2310, 2770. 
Ibid., 1906, vol. 21, pp. 961, 1553. 

TLACOTALPAN. 

Gourgues: Journal de Medecine de Paris, 1883, vol. 5, p, 234. 
Medical Record, 1883, vol. 24, p. 322. 

TISPLAN. 

Humboldt: Report Sanitary Commission, 1853, p. 127. 

TONOLA. 

Liceaga: Trans. Am. Pub. Health Assn., 1883, vol. 19, p^ 128. 
Ibid., 1902, vol. 28, p., 258. 

TUXPAN. 

GLiceaga: Trans. Am. Pub. Health Assn., 1893, vol. 19, pp. 123, 125,127. 

Ibid., 1902, vol. 28, p. 258. 

Berenger-Feraud, p. 140. 

Boyd: National Board of Health Bulletin, 1879-80, vol. 1, p. 309. 

Gourgues: Journal de Medecine de Paris, 1883, vol. 5, p. 233. 

U. S. Public Health Reports: 1896, p. 1200. 

Ibid., 1899, p. 2366. 

Ibid., 1907, p. 905. 

TUXTEPEC. 

TJ. S. Public Health Reports, 190 6,vol.. 21, p. 1553. 
Oourgues: Journal de Medecine de Paris, 1883, vol. 5, p. 234. 
Ibid., 1905, p. 2770. 

VALLrADOLID. 

U. S. Public Health Reports, 1903, vol. 18, p. 2310. 
Ibid., 1906, vol. 21, p. 1553.. 

VERA CRUZ. 

Alvarado (I.): Fiebre amarilla (en Veracruz). Gac. med. de Mexico, 



MRxico. 763 

1878, xiii, 433-452. Ibid., Apuntes para la historia de la fiebre amarilla 
que reina en Veracruz. Ibid., 1879, xiv, 45-68. 

Bernard (J.) : Etude sur la fievre jaune d'apres des notes recueillies 
a la Vera-Cruz (Mexique) pendant les annes 1862-1863-1864. 4° Mont- 
pellier, 1868. 

Buez: Note sur I'epidemie de fievre jaune de 1862, a la Vera-Cruz. 
Bull.. Acad, de Med., Par., 1861-2, xxvii, 960-962. 

Chabert (J. L».) : Reflecsiones medicas, y observaciones sobre la 
fiebre amarilla. Hechas en Veracruz de orden del supremo gobierno 
de la Federacion Mexicana. Trad, al espanol por 'C. Liceaga. 8°. 
[Mexico, 1827.] 

Crouillebois. L'epidemie de fiev.re jaune, en 1862, a la Vera-Cruz. 
Rec. de mem. de med mil.. Par., 1863, 3. s., x, 401-461. 

Del Rio (N.) : Informe que el subscripto, jefe del servico sanitario 
especial contra la fiebre amarilla en Veracruz, * * * g^ agosto de 
1904, Bol. d. Sons. sup. de salub. Mexico, 1905, 3. ep. vol. 10, p. 281. 

Fuzier: Resume d'etudes sur la fievre jaune observee a la Vera-Cruz 
pendant les epidemics qui se sont succedees de 1862 a 1867. 8°. Paris, 
1877. 

Fuzie.r: Co-incidence de la fievre jaune a Vera-Cruz avec des fievres 
intermittentes. Ibid, ix, 38-41. 

Kermorgant: Mortalite a Vera Cruz Pendant le Deuxieme Semestre, 
1902.— Ann. d'Hyg. et de Med. Coloniales, 1903, vol. 6, p. 427. 

Liceaga: Trans. Am. Pub. Health Assn., 1902, vol. 28, p. 259„ 

Ibid., 1905, vol. 30, p. 214. 

Mainegra (R. J.) : Yellow fever epidemic at Vera Cruz. Rep. Superv. 
Surg.-Gen,. Mar. Hosp., Wash, 1883-4, p. 241. 

Legris (M. H.) : Queiques mots sur l'epidemie de fievre jaune de 
1862 a Vera-Cruz. 4°. Paris, 1864. 

Naphegyi (Gabor) : Remarks on the Military Hospitals at Vera Cruz, 
and the diseases admitted in 1853-4, especially Yellow Fever and 
Vomito. New York Journal of Medicine, May, 1855. 

Porter (J. B.) : Treatment of the Vera Cruz yellow fever in 1847. 
Am. J. M. Sc, Phila., 1853, n.. s., xxvi, 312-333. 

Parker, Beyer and Pothier: Report on working party No. 2, Yellow 
Fever Institute. Experimental studies in yellow fever and malaria at 
Vera Cruz, Mexico. Wash., 1904, Govt. Print. Office, 101, p. 2 pi. 2 ch. 
8°. Forms Bull. No.. 14, of Yellow Fever Institute. Treas. Dept. U. S., 
Pub. Health & Mar. Hosp. Service. 

Rosenau, M. J. and Parker, H. B.: Experimental Studies in Yellow 
Feve,r and Malaria at Vera Cruz, Mexico. Yellow Fever Institute, 
Bulletin No. 14, 1905. 

Bouffier: Considerations sur les epidemics de fievre jaune et les 
maladies de la Vera-Cruz (Mexique) pendant la premiere moitie du 



764 HISTORY OF YELLOW FEVER. 

dix-neuvieme siecle d'apres. les registres de Thospice civil Saint- 
Sebastien. Arch, de med.. nav., Par., 1865, iii, 289, 520. Also, Reprint. 

Ruiz: Un caso notable de fiebre amarilla. Voz de Hipocrates, 
Mexico, 1883, i, 2. 

Saunier (J. B.) : Investigaciones sobre la fiebre amarilla o vomito 
de Vera Cruz. 8°. Puebla, 1866. 

Schmidtlein (A.) : Das gelbe Fiebre in Vera-Cruz 1865. Deutsches 

Consult also: 

Berenger-Feraud : Traite Theorique et Pratique de la Fievre Jaune, 
Paris, 1890. (Chronologie.) 

Annual Reports Surgeon-General U. S. Army, from First Volume to 
date. 

U. S. Public Health Reports, Vols. 1, 1886, to date. 

VICTORIA. 

U. S.. Public Health Reports, 1899, p. 2367. 

Ibid., 1903, vol. 18, p. 2310. 

Ibid., 1904, p.. 1304. 

Liceaga: Trans. Am. Pub. Health Assn., 1905, vol. 30, p. 214. 

XUMPICH. 

U. S. Public Health Reports, 1908, p. 1894. 

YUKI. 
Main: iMedical News, 1883, vol. 43, p. 529. 

ZONGONICA. 

Arch. f. kiln. Med.. Leipz., 1868.. iv, 50-109. Also, Reprint. 

U. S. Public Health Reports, 1903, vol. 18, p. 2310. 

ZUCATOLA. 

Main: Medical News, 1883, vol. 43, p. 419. 

YUCATAN. 

Thompson: Yellow Fever in Yucatan. U. S. Marine Hospital Service 
Public Health Report, vol. 18, p. 1315 (1903). 

GENERAL. 

Dutrouleau: La Fievre Jaune au Mexique. Gaz. Heb. de Paris, 1862, 
vol. 9, p. 457. 



MEXICO. 765 

Fleury (J.) : Vues hygieniques relatives a son epidemie de fievre 
jaune au Mexique. Union med. de la Gironde, Bordeaux, 1862, vii, 
pp. 589-596. 

Goupilleau: Remarques et observations sur la fievre jaune au 
Mexique. [Rap. de Chervin.] BulL Acad, de med., Par., 1838-9, iii, 305. 

Gourgues (O.): De I'Endemicite de la Fievre Jaune sur les Cotes 
Orientales de la Republique Mexicaine. J. de Med. de Paris, 1883, 
vol. 5, pp. 225, 257. Also: Bull. Soc. de Med. Prat, de Paris (1883) 
1884, p. 99. 

Heinemann (C): Beltrage zur Kenntniss des gelben Fiebers an der 
Ostkuste Mexiko's. Arch. f. path. Anat, etc., Berl., 1879, Ixxviii, 139- 
189. Also, Reprint. 

Heinemann (C.) : Estudios sobre le fiebre amarilla (vomito) en la 
costa oriental de la Republica Mejicana. Cron. med.-quir. de la 
Habana, 1882, viii, 353, 411, 474, 518, 566.. Ibid., Neue Beitrage zur 
Kenntniss des gelben Fiebers an der Ostkuste Mexico's. Ach. f. path. 
Anat. [etc.], Berl., 1888, cxii, 449-463. 

Heinemann (C.) : Estudios de la Fievre Amarilla (Vomito) en la 
Costa Oriental de la Republica Mejicana. Cron. Med. Quir. de la 
Habana, 1882, vol. 8, pp. 353, 411, 474, 518, 566., 

Humboldt (W.) : Extract from a Communication addressed to tTie 
Sanitary Commission cf New Orleans, on the Fever in Mexico. See 
Sanitary Report, New Orleans, 1854. 

Humboldt: Political Essay on the Kingdom of New Spain. 

Jimenez (M. F.) : Fiebre amarilla tomada en Vera Cruz y desenvuelta 
en Mexico. Gac. Med., Mexico, 1866, ii, 313-317. 

Liceaga (E.): Contributions to the Study of Yellow Fever from a 
Medico-Geographical point of view. (Mexico) Am. Pub. Health Assn. 
Rep. (1893), Concord, 1894, vol. 19, p. 112; (1897) 1898, vol. 23, p. 442; 
vol. 24, p.. 135, (Discussion) 328. Also: (Abstr.) Med. & Surg. Reporter, 
Phila., 1893, vol., 69, p. 701. 

Liceaga (E.) : Report on Yellow Fever in the Republic of Mexico 
from October 31, 1901, to September 30, 1902. Am. Pub. Health Assn., 
Rep. 1902, Columbus, 1903, vol. 28, p. 258. 

liiceaga (E.) : Yellow Fever in Mexico. Am. Pub. Health Assn. Re- 
ports, 1903, vol,, 28, p. 258; 1905, vol. 30, p. 214; 1906, vol. 31, p. 284; 
1907, vol. 32, pt. 1, p. 38. 

Liceaga (E): La fiebre amarilla en Mexico. Cron. Med. Quir de la 
Habana, 1905, vol. 31, p. 6. 

Liceaga (E.) : Contribucion al Estudio de la Fiebre Amarilla bajo 
el punto de vista de su Geografia Medica y su Profilaxia en la Repub- 
lica Mexicana. 8°. Mexico, 1894. 



766 HISTORY OF YELLOW FEVER. 

Mejia (D) : Mexico: Investigation of Suspected Yellow Fever on 
Pacific Coast. Pub, Health. Rep., U. S. Marine Hosp. Serv., Wash., 
1897, vol. 12, p. 290. 

Mendlzabal (G.) : Considerations upon the endemical character of 
yellow fever upon the coast of the Gulf of Mexico. Am. Pub. Health 
Assn. Rep. 1891, Concord, 1892, vol. xvii, 193-198. 

Mitchell (B. R.) : Yellow fever in Mexico. Med. Exam., Phila., 1848, 
n. s., iv, 285-291. 

Neue: Beitrage zur Kenntmiss des gelben Diebers an der Ostkuste 
Mexico's. Arch. f. Path. Anat. (etc.), Berl. 1888, vol. 112, p. 449, 

The Ravages of yellow fever in Mexico and Panama. Med. News, 
Phila., 1883, xliii, 419. 

Ruez (A.) : La fievre jaune au Mexique en 1862. Gas hebd. de med., 
Paris, 1862, ix, 738; 801. 

Ruiz y Sandoval (G.) : Fiebre Amarilla Epidemica a lo largo del 
Rio Bravo y del Litoral del Pacifico en los ano 1882-1883. Voz de 
Hipocrates, Mexico, 1884, vol. 2, p. 278, 286. 

Santos Fernandez (J.) : Yellow Fever is the Great Obstacle which 
is encountered by the Civilization of Spanish America. Translated by 
W. Thompson. 8°. Mexico, 1896. 

Thomas (L.) : Une Epimedie Mexicaine au Xviii Siecle., le Cocolisti 
ou matlazahuatl des Indiens. In his Lecture sur I'Hist. de la Med.. 8°. 
Par., 1885, p. 1. 

Yellow fever in Sonora. [Guaymas.] Pacific M. & S. J., San Fran., 
1884-5, xxvii, 118-120. 



767 



UNITED STATES. 

HISTORY OF YELLOW FEVER IN THE UNITED 
STATES, BY LOCALITIES, FROM 1668 TO 1909. 

General Nummary, 

Yellow fever has never been known to originate de novo 
in the United States of America. Previous to 1668, it 
was unknown in this country. It was imported from 
Havana to New York that year and caused much mor- 
tality. Twenty-three years later (1691) Boston was in- 
fected by the West Indies, and in 1693 Philadelphia and 
Charleston experienced their first visitations of the dis- 
ease, the infection in both instances being carried from 
the West Indies. 

In December, 1493, fourteen months after the discovery 
of America, while on his second voyage, Columbus landed 
on the island of San Domingo and founded the town of 
Ysabella. This was the first settlement by Europeans in 
the Western Hemisphere. That same month,' the little 
band of adventurers was attacked by a pestilential dis- 
ease whose symptoms were new to medical science, and 
which was no doubt the malady now known as yellow 
fever. This pestilence lasted three years, mowing down 
the Spaniards as fast as they arrived from the Old World. 
Ysabella. was finally abandoned in 1496, on account of its 
insalubriety and never rebuilt. 

Oviedo, Gomara and Herrera, chroniclers of the period, 
in their description of the pestilential sickness which 
decimated the Spaniards from 1493 to 1496, specially men- 
tion the yellowness of the skin of those afflicted at 
Ysabella. 

This is the first epidemic of yelloio fever recorded in 
history. 



768 HISTORY OF YELLOW FEYER. 

While cruising along the coast of San Domingo in 1494, 
Columbus w^s attacked by the ^'American Pestilence," 
and narrowly escaped death. His son, Ferdnand Col- 
umbus, in his interesting account of the voyages of the 
great explorer, speaks of the coma which accompanied the 
fever. 

On March 27, 1495, was fought the battle of Vega-Eeal, 
in which the handful of Spanish soldiers under Columbus 
put to flight ''a multitude of Indians." The natives, who 
looked upon the white men as gods, fled precipitatedly 
before the advancing foreigners. Shortly after the en- 
counter, the Spaniards were decimated by a worst enemy 
than the unoffending islanders — yellow fever, which from 
that day proved the greatest and almost unsurmountable 
obstacle to the colonization of the New World. 

The pestilence at Yega-Keal was so murderous and the 
epidemics which followed wherever the Spaniards at- 
tempted to establish a settlement in the West Indies were 
so frightfully mortal, that the King of Spain decided to 
send all the malefactors of his kingdom to Hispanola ( San 
Domingo), promising a full pardon to murderers after 
sojourning two years on the island. Those guilty of 
minor offenses were given their freedom if they escaped 
the terrors of the "Yellow Demon" after one year. It 
is a signiflcant fact that few returned to their native 
land. 

The following resume, made by the United States 
Marine Hospital Service, shows that in almost every in- 
stance the disease under discussion was carried to the 
seaboard cities of the United States by vessels from the 
West Indies : 



769 

TaRLK SIUnVlNG YEARS IN V. UlCH YELLOW FEVER HAS INVADED THE SEABOARD 

CITIES- OF THE United States, cities visited, and source of infection (1G68- 
1893), chronologically arranged. 

[In this table cases of yellow fever wbiclvLave been detected and detained at qiKvrantiT)0 ota-tiona are 
not considered. Epidemic years are marked witL an JE.] 



Tear. 



Locality 



Origin. 



Remarks. 



1668 

1691 
1603 



1693 
1693 



1697 



1699 !■: 



1699 
1702 E 



1702 
1703 



170.^. 
1728 



1729 
1732 E 



1732 E 



New York. 



TTest Indies. 



Boston 
do. 



.do 
-do 



Pbiladelpliia 

diarlestoij, S. C 



....do 
....do 



1095 Tliiladeli/bia. 



N'irgiuia. 



F'biladelpbia. 



.do 



Charleston, S. C. 
Ne-vy York 



Vi'cst^ Indies 



Biloxi, IMiss 

Cbarloslou, S. C. 



Mobile 

Charleston, S.C. 



L(»nisiana 

Charleston, S. C. 



West Indies 



rhiladelpbia. 



According to Toner the first appearance of 
yellow fever in the United States. (Report 
U. S. Marine-Hospital Service, 1873; J. H. 
Griscom, M. Rep., 1856, p. 561.) 

Infected for the iirst time by a vesoel from the 
West Indies. (B. Dowler, Tableau of Yel- 
low Fever, 1853, p. 7.) 

"Wlieeler's fleet brought the d'sease from Bar- 
bados and Martinique. (Hutchinson, History 
of New England, Vol. II, p. 72; and Ledird, 
New History of England, III, p. 110; also Ed. 
N. Y. J. M., 1856, p. 278, Toner.) 

La Roclje (Vol. I,i).48); accoi'ding to Toner 
the disease first visited Philadelphia in 1695 
and Charleston in 1699. Both authors attrib- 
ute tlie origin of the epidemic to boats com- 

. ing from the Antilles. 

According to Toner the first appearance of 
yellow fever on the Delaware (J. N.SchooI- 
tield, Va. Med. Jour., 1857, p. 358), brought by 
boat from the West Indies. (B6renger-F6- 
raud, p. 36.) 

The tleet of Admiral Nevil brought the disease 
from the West Indies to Virginia. The mor- 
tality was considerable. The admiral himself 
died, and of all tlie captains only one sur- 
vived. (Berenger-Ferand, Traitetheoretique 
et clinique de la fievre jaune, 1890, p. 37.) 

220 out of 2,000 or 3,000 inhabitants died of 
yellow i'e\er, called at the time the Barbados 
ifever. because it was brought by a ship from 
that island. (Bhllv. after Lytler, American 
Registers, Vol. I;'R. La Roche, Ch. M. J. 
and Rev., 1852, p. 58, Toner.) 

Simon's Trans. S. C. Med. Assn., 1851, p. 37, 
Toner. 

A severe epidemic, said to have been brought 
to the city by a bale of cotton from St. 
Tlionias. The' fever this year w-as carried 
along the lints of trade "as far as Biloxi. 
(B6renger-Foraud, loc. cit., p. 39.) 570death3. 
(J. H. Griscom, Visitation of Yellow Fever, 
p. 2.) 

Drake Dis. Int. Valley of N. A., 191. (Toner.) 

According to Kewelt the disease was brought 
by way of tlie sea. (B6renger-Feraud, loc. 
cit.) isimon's Trans. S. C. Med. Assn., 1851, 
p. 37. (Toner.) 

(P. H. Lewis. N. O. Med. Jour., 1845, Vol. I, 
p. 283.) 

(Carpenter, sketches from the history of yel- 
low fever, 1844, p. 11. Simon's Trans. S. C. 
Med. Assn., J851, p. 37. Toner.) 

Berenger-Ferand, loc. cit., p. 43. 

Severe epidemic, 8 to 12 deaths daily from May 
i^o October. ("Toner.) Brought to port by a 
vessel from the West Indies (Montrie and 
Linning) and Simon's Trans. S.C. Med. Assn.,; 
1851, p. 37. (Toner.) 

Carpenter, loc. cit., p. 11., Daily Shreveport 
Times, Vol. II, No. 311, 1873. (Toner.) 250 
deaths .(Berenger-F6raud, loc. cit.) 



770 

Table showing yeaks in which yellow fever has invaded the seaboard 
citip:s of the United States, etc. — Continued. 



Year. 



Locality. 



Origin. 



Eetaarks. 



X732 
1734 
1735 
1737 

1739 
1741 E 



1741 
1741 
1741 
1742 
1742 
1742 

1743 
1743 E 

1743 
1744 



1745 E 

1745 

1747 E 

1747 

1747 

1748 

1748 
1749 

1753 

1755 
1761 

1762 E 

1762 

17G2 

17C3 
1703 E 
1764 

17C5 



New York 

Charleston, S.C... 
New Havcu, Conn 
Norfolk 



Charleston, S. C. 



Philadelphia. 



Kerf oik 

New York . . . 

Boston 

Norfolk 

New York . . . 
Philadelphia. 



do...., 

New York . 



New Haven . 
Philadelphia. 



Charleston, S. C 



New York... 
Philadelphia. 

Norfolk 



New York 

Charleston, S. C 



Now York 

Charleston, S.C. 



-do 



Philadelpliic 



Charleston, G. C . 
New York 



Philadelpliia... 
Nantucket, M.. 
Pcnsacola 



"West Indies . 



-do 



.do 



"Wect Indies 



West, Indi 



West Indie. 



Mobile. 



J. H. Griscom, Visitation of Yellow Fever, 
p. 3. (Toner.) 

T, Harris. (Philadelphia M. and P. J., No. 5, 
P-2L) 

Pariset, quoted by Berenger-Eeraud, loc. cit., 
p. 45. 

The disease was brought to Virginia from 
the Antilles, according to Mitchell <fe Kush. 
(An account of the Bilious Vomiting Yellow 
Fever.) 

According to Linning and Ramsay. (Descrip- 
tion of yellow fever. Vol. II, p. 370.) The 
disease came from the West Indies. H. 
Hume, Ch. M. J. and Rev. 1854, p. 145. (To- 
ner.) Carpenter, loc. cit., p. 11. 

Carpenter, loc. cit., p. 12. The disease was 
brought to the city in June, presumably in a 
trunk of clothing from the West Indies. 
(Berenger-Feraud, loc. oit.) 250 deaths. (J. 
H. Griscom, Visitation of Yellow Fever, p. 3.) 

B6renger-Feraud. (Med. Repos., Aug. 1810.) 

Ed. N. Y. J. M., 1856, p. 278. (Toner.) 

15 deaths. (B6renger-Feraud, loc. cit,, p. 47^ 

Berenger-F6raud, loc. cit., p. 46. 

Ed. N. Y. J. M., 1856, p. 278. (Toner.) 

B. Dowler, Tableau of Yellow Fever, p. 3. 
(Toner.) 
Do. 

217 deaths, J. H. Griscom, Visitation of Yellow 
Fever, p. 3. (Toner.) 

Berenger-F6raud, loc. cit,, p. 48. 

Brought to the city by an infected ship from 
the West Indies. (B6renger-F6raud, loo. 
cit., p. 48.) R. La Roche, Ch, M. J. and Rev., 
1852, p. 458. (Toner.) 

According to Linning, brought to port by an 
infected ship from the West Indies. (Ber- 
enger-Feraud, loc. cit.) W. Hume, Ch. M. J, 
and Rev,, 1854, p. 145. (Toner.) 

J. H. Griscom, Visitation of Yellow Fever, p. 

3, (Toner.) 

Currie, Rush, and Bally. (Berenger-r6raud, 

loc. cit.) R. La Roche, Ch. M. J. and Rev., 

1852, p. 458. (Toner.) 
Bally. (B6renger-F6raud, loc. cit.) Daily 

Slireveport Times, Vol. II, No, 311, 1873. 

(Toner,) 
J. H. Griscom, Visitation of Yellow Fever, p. 

4. (Toner.) 

The disease this year was, according to Moul- 
trie and Linning, imported by a contami- 
nated vessel from the West indies. B6r- 
enger-F6raud, loc. cit.) W. Hume, Ch. M. J, 
and Rev., 1854, p. 145. (Toner.) 

Daily ShreVeport Times, Vol. II,No.8Jl, 1873. 
(Toner.) 

Moreau de Jonn^s. (Monographie historique 
et m6dicale de la fievre jaune, Paris, 1820, 
p. 56.) 

Sijoradic. (Linning and Ramsay.) W. Hume, 
Ch. M. J. and Rev., 1854. p. 145. (Toner.) 
Do. 

Harris. Philadelphia M. and Ph. J., 1805, p. 21. 
(Toner.) 

Severe epidemic started by si sailor from Ha- 
vana, who communicated the disease to his 
family. (Redman, quoted by Bally.) J. H. 
(Jriscom, Visitation of Yellow Fever, p. 5. 
(Toner.) 

Dawson and Do Saussure, Census^of Charles- 
ton. (Toner.) 

Daily Shreveport Times, Vol. II, No. 811, 
1873. (Toner.) 

Si)oradic. (Rush.) 

259 deaths (Toner), Med. Rep. 1853, p. 107. 

P. S. Townsend. N. Y. M. and Ph. J., 1323, 
p. 315. (Toner.) 

Drake, Dis, Int. Valley of N. A., p. 216. 
I (Toner.) 



771 

TaBLK SllOWlXr, YKAKS IS WHICH YELLOW FEVER HAS INVADED THE SEABOARD. 

CITIES OF THE UNITED STATES, ETC. — Continued. 



Year. 


Locality. 


Origin. 


Remarks. 


1765 E 


T-*fin<»nmIa 


West Indies 


A British garrison was sent from England to 
occupy the city, and coming by tlie way 
of the West Indies, introduced the disease. 
(Monette-Williams, Carpenter.loc. cit., p. 12.) 
125 deaths. (Lind, Vol. I, p. 45; Bcreiiger- 
F^raud, loc. cit., and Drake Dis. Int. Valley 
of N. A., p. 190.) 

P. H. Lewis, N. 0. M. J., Vol. I, No. 4, 1845, 


1766 


Mobile 


1768 


Charleston S. C 




p. 283. (Toner.) 
M. M. Dowler, N. 0. M. J., 1859, p. 305. (Toner.) 
The first appearance of yellow fever in New 

Orleans. (S. Chaille, Va. M. J., 1858, p. 498. 

Toner.) 
T. Harris, Phila. M. and Ph. J., 1805, p. 21. 

(Toner.) 
Webster, quoted by Bcrenger-Fcraud, loc. cit., 

p. 57. 
Berenger-Feraud, loc. cit., p. 58. 
Do 


1769 


"Nri'vc r)rlfiaTiH 




1770 


Cbarleston S. C . ... 




1783 


Tlalt.imnrA 




1789 


Norfolk.. 




1789 


Baltimore 




1789 


Philadelphia 




Do. 


1789 E 


New York 




W. flume, Ob. M. J. and Rev., 1860, p. 24. 
(Toner.) 

Sporadic. (Bally.) 

S. Chaille, Va. M. J., 1858, p. 498. (Toner.) 

B6rengeF-F6raud, loc. cit., p. 58. 

Ed. N. Y. J. M., 1856, p. 278. Report on Quaran- 
tine on the Southern and Gulf Coasts of the 
TJ. S. (H. E. Brown, 1873.) 

W Hume Ch M J and Rev 1852"*'^ 145. 


1790 


do 




1791 


New Orleans 




1791 


Philadelphia 




1791 E 


New York 




1792 


Charleston S C 




1792 


New York 




(Toner.) 

Ed. N. Y. J. M.. 1856, p. 278. 

Trans. A. M. A., Vol. II, 1853, p. 665. (Toner.) 

Carpenter, loc. cit., p. 12. 4,044 deaths in 3 
months in a population of 55,000. (Rush.) 
The epidemic is said to have started in a 
sailors' boarding house, where the crew of a 
French corsair (which hart been contami- 
nated at the West Indies) were stopping. 
B6renger-F6raud, loc. cit,, p. 60. Carey, Ac- 
count of the Malignant Fever, p. 116. 
(Toner.) 

The infection was brought to this port by a 
vessel from Martinique. One of the crew 
died en route. All yrere well upon arrival. 
The first case occurred at the house where the 
captain was stopping. (Berenger-Feraud, 
loc. cit., p. 62.) 

Introduced by vessels from the West Indies, 
many of which brought refugees who fled 
from Santo Domingo. A vessel entered from 
Santo Domingo with several cases of yellow 
fever on board. (Carey; Carpenter, loc. cit., 
p.ia.) Sporadic, Ed. N. Y. J. M., 1856, p. 
278. (Toner.) 

Stethoscope, Vol. Ill, No. 11, 1853, p. 665. 
(Toner.) 

W. Hume, Ch. M. J. and Rev.. 1852, p. 145. 
(Toner.) 

J. H. Griscom, N.Y. J. M.,1856,V. 369. (Toner.) 

W. Hume, Ch. M. J. and Rev., 1860, p. 24. 
(Toner.) 

La Roche, B. of H. Rep., Phila., 1870, p. 53. 
(Toner.) 

Ed. N.Y. J. M., 1856, p. 278. (Toner.) 

By boat from the Antilles. (Med. Jo^ir.. 1812, 
p. 28.) 

Brought there by a trunk of effects of nn indi- 
vidual who died of the disease at Martiui<i^ue. 
Three persons who assisted in openiu^^ the 
trjiuk died of yellow fever in a few cays. 
(Berenger-Feraud, loc. cit., p. 63; W. Huiiie, 
Ch. M.J. and Rev., 1860, p. 24). (Toner.) 

Stethoscope, Vol. Ill, No. 11, 1853, p. 665. 
(Toner.) 

W.IIume, Ch. M. J. and Roy., 1852, p. 145. 
(Toner.) 

J. H. Griscom, N.Y. J. M.,1850, p. 3CD. (Toner.) 

Toner (U. S. M. H. S. Rep., 1873) and Berenger- 
Feraud, loo, cit. 


1793 E 


New Orleans 




1793 E 


Philadelphia 


West Indies 

. . . do 


1793 


Portsmouth, N H 


1793 


New York 


do 


1794 E 






1794 E 

1794 
179 J 


Charleston, S. C 

Norfolk 

Baltimore 




1794 E 


Philadelphia 




1794 


New York 




1794 


Providence, R. I 

New Haven, Conn 


West Indies 


1794 


do 


1795 E 




1795 

1795 
1705 


Charleston, ^.C 

Norfolk , 

Baltimore 








1 



772 

Table showing yeaks in which yellow fever has invaded the seaboard 
CITIES of the United States, etc. — Coiitinued. 



Tear. 



Locality, 



Origin. 



Remarks. 



1795 E 



1795 E 
,1795 

1795 

1796 E 
1796 
1796 
1796 

1796 
1796 
1796 
1796 
1796 



1796 

1797 

1797 

1797 
1797 

1797 
1797 E 

1797 E 



1798 E3 

1798 
1798 
1798 E 



1798 E 

1798 
1798 E 
1798 E 

1798 E 

1798 E 
1798 E 



1798 



1798 

1798 E 
1798 

1799 E 



1799 E 



New York 



West Indies. 



Philadelphia 

Providence, R. I 



Boston. 



New Orleans 

Wilmington, N. C 

Norfolk 

Philadelphia 



New York 

Providence, R. I 

Newburvport, Mass 
Portsmouth, N.H... 
Charleston, S. C 



West Indi( 



Boston. 



.do 



New Orleans 

Charleston, S.C. 



Norfolk 

Baltimore... 



New York ,. 

Providence, R. I 



West Indies. 



Philadelphia. 



.do 



Charleston, S. C- 



Cheeter, Pa 



Newcastle, Del. .. 
Wilmington, Del. 
New York 



Boston 



Salem, Mass ,. 

Portsmouth, N. H 



Newburyport, Mass. 



Hartford, Conn 

New London, Conn 
Stonington, Conn 
New Orleans . 



Charleeton, S.C. 



West Indies . 



West Indies , 




The disease was brought here by the brig 
Zephyr from Port au Prince. There were 
700 deaths in 3 months in a population of 
40,000. (B6renger-F6raud, loc. cit., p. 64; 
Bay ley s Account of Yellow Eever, 1795.) 

B6renger-E6raud, p. 64. 

W. Hume, Ch. M. J. and Rev., 1860, p. 24. 
(Toner.) 

Dowler, Tableau of Yellow Fever, 1853, p. 7. 
(Toner.) 

Stethoscope, Yol. lU, No. 11, 1853, p. 665. 

J. H. Griscom, N. Y. J. M., p. 369, 

Va, M. J.,1857,p.95. (Toner.) 

J. H. Griscom, N.Y.J. M., 1856, p. 368 and 369. 
(Toner.) 

Ed. N. Y. J. M., 1856, p. 278. 

Berenger-F6raud, loc. cit., p. 64. 

J . H. Griscom, N. Y, J. M., 1856, p. 369. 

B6renger-Feraud, loc. cit.^. 65. 

Brought by a vessel from Havana. (B6renger 
Feraud, loc. cit., p. 65.) W. Hume, Ch. M. J, 
and Rev., 1852, pi.. 145. 

According to Warren, brought by a vesselfrom 
St. Domingo. (B6renger-F6raud, loc. cit., p 
65.) J. H. Griscom, N. Y. J..M., 1856, p. 369. 

Stethoscope, Vol. HI, No. 11, 185?, p. 665 
(Toner.) 

W. Hume, Ch. M. J. and Rev., 1852, p. 145 
(Toner.) 

J. H. Griscom^N. Y. J. M.,1866,p. 369. (Toner.) 

J. H. Griscom, Visitation of Yellow Fever, p. 8 
(Toner.) 

Ed. N. Y. J. M., 1856, p. 278. (Toner.) 

The disease w-as brought here by the Betsy 
from the West Indies. (B6renger-F6raud, 
loc. cit., p. 65.) 45 deaths, Dowler, Tableau of 
Yellow Feyer, p. 10. 

The college of physicians of Philadelphia 
attributed the introduction of the disease 
this year to the L' Arethuse with slaves from 
Jamaica and Havana. (B6renger-F6raud, 
loc. cit., p. 65.) 1, 300 deaths, Rush, Epidemic 
of 1797. (Toner.) Dowler, p. 10, loc. cit. 

T. Y. Simons, Ch. M. J. and Rev., 1851, p. 779, 
(Toner.) 

Va. M.J.,1857,p. 95. (Toner.) 

W. Hume, Ch. M. J. and Rev., 1860, p. 24. 

The disease was brought by a vessel from St. 
Domingo. (Caillot, p, 213, and Currie, quoted 
by Berenger-Feraud, loc. cit., p. 66.) 3,500 
deaths. Rush, epidemic of 1798. (Toner.) 

50 deaths, J. H. Griscom., Visitation of Y jllow 
Fever, p. 9. (Toner.) 

J. Stephens, Med. Mus., 1809, p. 153. (Toner.) 

250 deaths, Med. Mus., 1809, p. 153. (Toner.) 

2,080 deaths, Ed. N. Y. J. M., 1856, p. 278. 
(Toner.) Carpenter, loc. cit., p. 13. 

200 deaths, J. H. Griscom, N. Y. J.M.. 1856, p. 
369. (Toner.) 

J. Gotham, jr., Med. Rep., 1856, p. 563. (Toner.) 

100 deaths, brought by a ship from Martinique. 
(Moreau de Jonues, p. 178.) 

Brought to the city by an infected vessel, the 
Sally, with sick aboard. Five days after her 
arrival the disease declared itself. (Berenger- 
Feraud, loc. cit., p. 67.) 

Brown, Quarantine, p. 8. (Toner.) 

81 deaths, Ed. M. Repos., 1799, p. 211. (Toner.) 

J. Coraatock, M. Repos., 1807, p. 23. (Toner.) 

A severe epidemic year. Old. acclimated in- 
habitants died of the disease. (Berenger- 
Feraud, loc. cit., p. 67.) S. Chaille, Va. M. J., 
1858, p. 498. (Toner.), 

Contaminated by a Spanish vessel; 239 deaths. 
(B6ronger-Feraud, loc. cit., p. 07.) 239 deaths. 
W. Huke, Ch. M. J. and Rev., 1854, p. 145, 
(Toner.) 



1 A severe epidemic year. 



773 

Table showing years in which yellow fever has invaded the seaboard 
CITIES OF the United States, etc. — Continued. 



Locality. 



Origin. 



Eemarks. 



Norfolk . . . 
Baltimore. 



I*hiladelphia. 



New York . . . 
New Orleans. 



West Indies 



Charleston, S. C... 

Wilmington, N.C. 
Norfolk 



Baltimore. 



Philadelphia 

New York 

New Bedford, Conn 

Hartford, -Conn 

Providence, B. I 



Boston. 



New Orleans. 

Norfolk 

Baltimore ... 



Philadelphia 

New York 

Block Island, R. I.. - 
New Bedford, Mass. 

Savaanah, Ga 

Norwich , Conn 

Philadelphia 



West Indies . 



New Orleans. 



Charleston. 



Norfolk 

Wilmington, Del. 

Baltimore 

Boston 



New York . 



New Orleans 

Charleston, S.C. 



Norfolk. 



Philadelphia. 
New York... 



New Haven, Conn 

New Orleans 

Charleston 



Norfolk 

New Haven, Conn 
Charleston 



Norfolk 

Baltimore 



Va.M.J.,1857,p.95 (Toner.) 

W. Hume, Ch. M. J. and Kev., 1860, p. 24. 
(Toner.) 

The disease is said to have been brought here 
this year by the sloop La Marie taken by the 
LeGange. (B^reuger-reraud.loc. cit.,i».67.> 
1,000 deatiis. La Koche, Ch. M.J. and Kev. 
1852, p. 458. (Toner.) 

76 deaths, Ed. N. Y. J. M., 1856, p. 278. (Toner.) 

Infected by a vessel from Havana. ( B6renger- 
Feraud, 'loc.cit., p. 68.) S. Cbaille, Va. M. J., 
1858, p. 498. (Toner.) 

184 deaths, W. Hume, Ch. M. J. and Rev., 1854, 
p. 145. (Toner.) 

M. Repos., ]800, p. 197. (Toner.) 

250 deaths, Med. Repos., Vol. IV, p. 329. 
(Toner.) 

W. Hume, Ch. M. J. and Rev., 1860, p. 24. 
(Toner.) 

Dowler, loc. cit., 1854. p. 10. 

21 deaths. Ed. N. Y. J. M., 1856, p. 278. (Toner.) 

Brown, Quarantine, p. 9. (Toner.) 

M, Repos., 1800, p. 197. (Toner.) 

W. Hume, Ch. M. J. and Rev., 1860, p. 24. 
(Toner.) 

S. Emleu, N. A. M, jtfitd 6. J., 1828, p. 321. 
(Toner.) - 

S. Chaill6, Va. M. J., 1858, p. 498. (Toner.) 

Va. M. J., 1857, p. 95. (Toner.) 

W.Hume, Ch. M. J. and Rev., 1860, p. 24. 
(Toner.) 
Do. 

140 victims, Dowler, loc. cit., 1854, p. 11. 

Aaron C.Willev, M. Repos., I860, p. 24. (Toner.) 

B. Dowler, loc. cit., 1854, p. 11. 

B. Dowler, loc. cit., p. 11. 
Do. 

Probably brought to the city this year by the 
corsair le Sans-Culottes de Nantes, which 
captured the Spanish ship la Flore, with yel- 
low fever, from the Antilles, and brought the 
prize to the city. On the 3d of August, four 
days after the arrival of the coraail-, the 
disease appeared in a hostelry frequented 
by the crew; 307 deaths followed. (Gatliral 
and Currie, Bally, p. 455; B6renger-F6raud. 
p. 71; Carpejitef, sketches from history of 
yellow fever; also W. Hume, Ch. M. J. and 
Rev., 1860, p. 24. (Toner.) 

B. Dowler, Tableau of Yellow Fever, 1853, p. 12. 
(Toner.) 

90 deaths, W. Hume, Ch. M. J. and Rev., 1854, 
p. 145. (Toner.) 

Va.M.J.,1857,p.95. (Toner.) 

86 deaths. Med. Repos., 1803, p. 235. (Toner.) 

M. Repos.. 1803, p. 100. (Toner.) 

60 deaths, J. Gotham, Med. Rep., 1856, p. 563. 
(Toner.) 

2 deaths at Marine Hospital, W. Hume, Ch. M. 
J. and Rev., 1860, p. 24. (Toner.) 

B6reuger-r6raud. loc. cit., p. 73. 

Simon's Trans. S. C. Med. Assn., 1851, p. 37. 
(Toner.) 

200 deaths. (B6renger-F6raud, loc. cit., p. 73.) 
Va. M. J., 1857, p. 95. (Toner.) 

195 deaths, W. Hume, Ch. M. J. and Rev,, 1860, 
p. 24. (Toner.) 

600 to 700 deaths, Ed. N. Y. J. M., 1856, p. 278. 
(Toner.) 

Brown. Quarantine, 1872, p. 9. (Toner.) 

S. Chaill6, Va. M. J., 1858,> 498. (Toner.). 

148 deaths, Simons Trans. S. C. Med. Assn., 
1851, p. 37. (Tonei-.) 

Va. M. J., 1857, p. 95. (Toner.) 

Brown, Quarantine, 1872, p. 9. (Toner.) 

Simon's Trans. S. C. Med. Assn., 1851, p. 37. 
(Toner.) 

..Va. M. J., 1857, p. 95. (Toner.) 

J. H. Griscom. Visitatiou of Y^ow Fever, 
p. 1<{. (Toner.) 



TaBLR showing years in which yellow 1 ever has invaded the SEABOAIID 

CITIES OF THE UNITED STATES, ETC. — Continued. 



Year. 



Locality. 



Origin. 



Eemarlis. 



1805 E 



1805 



1805 

1805 E 

i806 
1806 

1807 
1807 

1807 E 

1807 

1807 



Philadelphia West Indies 



New Haven, Conn . . . 
Providence, R. I 



Boston 

New York 



Richmond. Va 

Newport, R. I 

St. Augustine, I'la 
Savannah , 



Charleston, S. C ... 

Philadelphia 

New York. 



1808 E St. Marys, Ga 



1808 

1808 

1809 
1809 

1809 

1809 E 

1810 

1810 

1810 

1811 
1811 
1811 

1811 



1812 
1812 

1813 

1814 

1815 

1815 

1816 

1816 
1817 E 



1817 
1817 E 



X817 



New York. 
Savannah . 



New Orlean.- 
Philadelphia. 



New York. 



Brooklyn 
Pensacola ... 
Philadelphia. 



New York 



Pensacola 

New Orleans 
Philadelphia. 



Perth Amboy, N.J 



New Orleans . . . 
Charleston, S. C. 



Philadelphia 
Philadelphia 
Philadelphia 
New York... 
Philadelphia. 



New Tork . . . 
New Orleans. 



Savannah 

Charleston, S. C. 



New York "... 

5053— VOL I- 



"West Indies , 



Savannah. 



West Indies 



West Indies 




■28 



Brought to the city by the schooner Nancy 
from St. Domingo. The disease extended 
along the Delaware to Chester. (Berenger- 
F6raud, loc. cit., p. 80. > 300 to 400 deaths, 
Hume, Ch. "M. J . andRev., 1860, p. 24. (Toner.) 

B. Dowler, Tableau of Yellow Fever, p. 13. 
(Toner.) 

Presumably brought to the city by three ves- 
sels, Saiute-Croix, Antigua, and La Havane, 
from the West Indies, Med. Journal. 1S12, 
p. 28. (Beranger-Feraud, loc. cit.,p. 81.) 

J. H. Griscom, Visitation of Yellow Fever, 
p. 13. (Toner.) 

310 deaths, J. H. Griscom, M. Rep. , 185C, p. 561 . 
(Toner.) 

M. Repos., 1807, p. 215. 

Toner (U. S. M. H. S. Rep., 1873), and Berenger- 
F6raud, loc. cit., p. 81. • 

Brown, Quarantine, p. 32. (Toner.) 

B. Dowler, Tableau of Yellow Fever, p. 14. 
(Toner.) 

162 deaths, Simon's Trans. S. C. Med. Assn., 
p. 38. (Toner.) 

3 deaths, B. Dowler, Tableau of Yellow Fever, 
1853. p. 14. (Toner.) 

3 deaths at Marine Hospital, J. U. Griscom, 
M. Rep., 1856, p. 561. (Toner.) 

The Polly arrived at St. Marys, Ga., from Sa- 
vannah with two cases on board. The sick 
disembarked and communicated the disease 
to the village; of 350 white inhabitants over 
300 died; of 150 negroes, only 3 died of the 
disease. (Berenger-Feraud, foe. cit.. p. 82.) 

One death at Marine Hospital, Ed. N. Y. J. M., 
1856, p. 284. (Toner.) 

B. Dowler, Tableau of Yellow Fever, p. 14. 
(Toner.) 

S. Chaill6, Ya. M. J., 1858, p. 498. (Toner.) 

B. Dowler, Tableau of Yellow Fever, 1853. i>. 14. 
(Toner.) 

By ship Concord from Havana, Ed. N. Y. J. M., 
1856, p. 284. (Toner.) 

40 deaths, Ed. N. Y. J. M., 1856, p. 278. (Toner.) 

Berenger-Feraud, loc. cit., p. 83. 

3 deaths, B. Dowler, Tableau of Yellow Fever, 
1853, p. 14. (Toner. ^ 

1 death at Marine Hospital, Ed. N. Y. J. M., 
1856, p. 2S4. (Toner.) 

Drake Dis. Int. Yalleyof N. A., p. 190. (Toner.) 
S. Chaille, Ya. M. J., 1858. p. 498. (Toner.) 

5 deaths, B. Dowler, Tableau of Yellow Fever. 
1853, p. 14. (Toner.) 

The brig Favorite brought the distasc from 
Havana to Perth Ainhoy. (Boweuon the 
Yellow Fever.) (Report.s of the X. Y. IJ.c.f 
H., Vol. IV p. 335.) (Berenger-FOraud, loo. 
cit., p. 83.) 
S. Cbaill6, Va. M. J.. 1858, p. 498. (Toner.) 
W. Hume, Ch. M. J. and Rev., 1854, p. 145» 
(Toner.) 

6 deaths, B. Dowler, Tableau of Yellow Fever.. 
1853. p. 14. (Toner.) 

Tdeatlis, B. Dowler, Tableau of Yellow Fever, 
1853, p. 14. (Toner.) 

2 deaths, B. Dowler, Tableau of Yellow Fever, 
1853, p. 14. (Toner.) 

7 deaths at Marine Hospital, Ed. N. Y. J. M., 
1856, p. 284. (Toner.) 

2 deaths, B. Dowler, Tableau of Yellow Fever, 

1853, p. 14. (Toner.) 
Ed. N. Y. J. M., 185gj,p. 284. (Toner.) 
Brought by the Eii^glish cutter Phtenis from 

Havana.' (Carpenter, loc. cit., p. 17.) 8.ii) 

deatlis. S. Chaill6, Va. M. J., 1858, p. 498. 

(Toner.) 
B6renger-Fcraud, loc. cit., p. 88. 
272 deaths, Dowler, N. O. M. J., J 859, p. 597. 

(Toner.) 

4 deaths at marine hospital, Ed. N. Y. J. M., 
1856, p. 281. (Toner.) 



775 



TaHLE Sir()\VlN<; years in which YF.LI.OW T KVF.Ii ITAS INVADKH 

CITIES OK THE UNITED STATES, ETC.— Continued. 



THE SEAr>OARl> 



Year. 



1818 E 
1818 



Locality 



Charleston, S. C. 
New York 



Baltimoro. . . 
New Orlean.' 



.do 



Mobile. 



Savannah 

Charleston, S. C 



I'hilach'lphia 



Baltimore 

New York. 

New Haven, Conn 
Boston 



New Orleans. 



Savannah 

Baltimore 

Philadelphia 



Now York 

Middle to ^^^l, Conn 
St. Augustine, Fla 



Savannah 

Mol.ile 

Wilmington, N. C. 

Baltimore.... . 

Norfolk. 

New York 

Pensacola 



New Orleans. 



Mobile. 



Charleston, S. C 

Baltimore 

New York 



New Orleans. 



Key West 
New York. 



Brooklyn, N.Y. 



Natchez, Miss ... 



Origin. 



Havana 



West Indies . 



Havana 



Saiitiaj:C<> do Cuba. 
Ifavaua 



Uavan; 



Pensacola. 



Havana. 



New Orlexins- 



.do 




Remark f 



115 deaths, (B6renger-Feraud, loc. cit., p. 88.) 

4 deaths at marine hospital, Ed. N. Y. J. M., 
1856, p. 281. (Toner.) 

Carpenter, loc. clt., p. 13. 

115 deaths. Dewier, N. O. M. J., 1859, p. 308. 

(Toner.) 
Inlected by a vessel from Havana. (Berenger 

r6raud, "loc.' cit., p. 89.) Tiiere were 2,190 

deaths. (S. Chaill6, Va. M. J., 1858, p. 498, 

Toner.) 
274deaths, P. H.Lewis.N.O. M..T.,Vol. r, No.4. 

1845, p. 284. (Toner.) 
A. M.Rec.,1820, p.212. (Toner.) 
117 deaths, Dowler, N. O. M. J., 1859. p. 597. 

(Toner.) 
13 deaths, S. Emlen, N. A. M. and S. J., 1828, 

p. 321. (Toner.) 
D. M. Reese, Yellow Fever, 1819, p. 27. (Toner.) 
37 deaths, Ed. N. Y. J. M.. 1856, p. 281. (Toner.) 
¥. Pascalis, M. Repos., 1820, p. 239. (Toner.) 
S. Emlen, N. A. M. and S. J., 1828, p. 321. 

(Toner.) 
Carpenter, loc, cit. (S.Chaill6, Va, M, J.. 1858, 

n.498.) 
N^. 0. M. and S. J., 1827, p. 1. (Toner.) 
H. G. Jameson, A.J. M. C, 1850, p. 372. (Toner.) 
83 deaths, S. Jackson, A. M, Rec, 1821, p. 689. 

(Toner.) 
2 deaths at Marino Hospital. Ed. N. Y.J.M., 

185G, i>. 281. (Toner.) 
Cari)enter, loc. cit., and M. TuUy, N. Y. M. and 

I'h. J., 1822, p. 153. 
( 'arp<;nter, loc. cit. The disease was brought to 

the United States from Havana, and was 

severe in several localities. (B6renger-F6r 

and. loc. (it., ]». 90.) 140 deaths, J. Gotham 

M. Rep., 1850, p. 564. (Toner.) 
i'.erenger-Feraud, loc. cit., p. 89. 
Drake, Dis. Int. Valley of N. A., p. 191. (Toner.) 
.1. B. Hill, A.M. IJec, 1822, and Brown, Quaran- 
tine, p. 18. (Toner.) 
H.CJ. Jameson, A. J. M. C. 1856, p. 372. (Toner.) 
V;i. M. J., 18.^)7, p. !)5. (Toner.) 
16 deaths at Marine, Hospital. Kd. N. Y. J. M., 

1856, p. 281. (Toner.) 
Broughtto the I'nited States by emigrants from 

tiie W(;st. IimUcs. (Berengor-Feraud, loc. 

cit., p. 100.) Carpenter, loc. cit. 259 de.atha, 

Drake, Dig. Int. Valley of N. A., p. 229. 

(Toner.) 
L'iUl deaths. Tranji. A. M. A., 1851, p. 207. 

(Toner.) Refugees from Pensacola carried 

the disease on the Ann and Elisa to New 

Orleans. (Berengor-Feraud. loc. cit., p. 100, 

and Carpenter.) , 

Drake, Dis. Int. Valley of N. A., p. 101. 

(Toner.) 
2 deaths, N. O. M. J., 1859, p. 597. (Toner.) 
M. G.Jameson, A.J. M. C, 1856, p. 372. (Toner.) 
Tiieship Enterprise from Havana broughttho 

disease into ])ort. ( Berenger- F6raud, loc. 

cit., ]). 100, and Carpenter, loc. cit.) 230 

deaths, Ed. N. Y. J.M., 1856, j). 281. 
The lirst case occurred among West Indies* 

shi[>ping. (Carjienter.) 1 death. Trans., A. 

M. A., 185],i». 207. (Toner.) 
Berenger-Feiaud, loc. cit., p. 100. 

5 deatii.s at Marino Hospital, Ed. N. Y. J.'M., 
1856, p. 281. 

Infected by the Diana, which left New Orleana 
at the height of the epidemic. The vessel 
was detained in quarantine 30 days without/ 
disinfection. (Berenger- Feraud, loc. cit.. p. 
100.) Carpenter, Sketches of Yellow Fever. 
(Toner.) ^ 

Berenger-Fcraud, loc. cit., p. 100, and Carpea* 
tcr. 



776 
Tahlk 



;iIONVIN(i YEAllS IN AVHICIl YELLOW TEVILU HAS INVADED THE SEAUOARLK 
CITIES OF THE UNITED STATES, i; IX;.— Coilt illlied. 



Year. 



Locality. 



Orisiii. 



lUniarks. 



1824 E 



1824 
1824 

J 824 Oi 

1824 

1825 E 

1825 

4825 

1825 

1825 

182G 

1826 
1820 

1827 E 

1827 

1827 
1827 
1827 

1827 

1828 E 

1828 E 
1828 
1828 

182'J JO 

1829 E 
182!> 
1829 
1820 E 

1830 E 
1830 

1831 

1831 
1832 

1832 

1833 E 
1833 

1834 E 
1834 E 



2s ew Uiie;iiis ! Havana 



Key West 

Mobile 



Ciiarlestoii... 
Isew York ... 
Is^ew Orleans. 
Mobile 



(.;iiarles(on,S. C. 

]S'o\v York 

Nev;OrU:ui.s.... 



Norfolk 

New York.*.... 



New Orleans. 
Mobile 



Pensacola 

Savaiinaii 

Cbarlestou, S. C. 



Now York . . . 
New ()rlean3. 
Charletiton... 

Mobile 

New York ... 



New Orleans. 
I Mobile....... 

I Key West.... 

New Yorli... 

New Orleans. 

Charleston .. 

New York... 



New Orleans. 



Savannah.. 
New York. 



Now Orleans. 

...do 

New York... 
...do 



Charleston 



118 deaths. Brought to the city this year by 
oUo of the crew of a barge. The inan had. 
comuuinication witli the -sciiooner Emig:rantv 
Iroiu Havana, which boat liad yellow fever 
cases on board. {HOrenger-Fcraud, loc. eit., 
p. 102; also Carpenter and Trans. A. M. A., 
W51.i).207.) 

B. Tieknor, N. A. M. and S. J., 1827, p. 213. 
Drake, Dis. Int. Valley of N. A., p. 191. (To- 

235death9, DowlerN.O.M.J.,1850,p.597. (To- 
ner.) 

S deaths at Marino Hospital, p]d. N. Y. J. M.>» 
1850, p. 281. (Toner.) 

40 deaths, 'frans. A. M. A.. 1851, and Drake, 
p. K)7. (Toner.) 

Drake, Dis. Int. Valley of N. A., p. 219. (To- 
ner.) 

■\TestIndian vcs.sel. (Am. Pub. Health Assn., 
Vol. IV.) Brown, (Quarantine, p, 30. (Tonr-r.) 

2 deaths, Dowler, N. O. M. J.. 1859, p. 597. 
(Toner.) 

1 death at .Marino Hospital, Ed. N.Y. J. M., 1856, 

p. 281. (Toner.) 
5 <lcath3, Trans. A. M. A., 1851, p. 207, and 

Drake, p. 197. (Toner.) 
Conaniittee's report, p. 14. (Toner.) 

2 deaths at Marine Hospital, Ed. N. Y. J. M., 
1856, p. 281. (Toner.) 

109 deaths, Trans. A. M. A., 1851, p. 207, and 
. Drake, i>. 197. (Toner.) 
Drake. Dis. Int. Valley of N. A., p. 219. 

(ToTifr.) 
Med. Statistics, 11, S. Army, p. 58. 
N4;). M. and S. J ., Vol. X. p. 145. (Toner.) 
64 deaths, Dowler, N. 0. M. J., 1859, p., 597.. 

(Toner.) 
4 deaths at Marine, Hospital, Ed. N.Y. J. M.. 

185G, ]>.281. (Toner.) 
130 deaths. Trans. A. M. A., 1851, p. 207 and 

Dralie, p. 197. (Toner.) 
26 deaths, Dowler, N. O, M. J.. 1859, p. 597. 

(Toner.) •. 

Drake, Dis. Int. Valley of N. A., p. 191. 
-HToner.) 
Soveraleases(l!ircnger-Feraud,loc. eit. p. 105), 

no deaths, E<1. N. Y. J. M.. 1H56, p. 281., 

(Toner.) 
215 deaths. Trans. A. M. A. 1851, p. 207 and 

Drake, p. 197. (TortBr.) 
130 deaths, Drake. Dis. Int. Valley of N. A., 

p. 191. (Toner.) 

C. C. BuinC; Am. J. of Med. Sci., 1841, p. 380. 
(Toner.) 

No deaths, Ed. N. Y. J. M.. 1856, p. 281.. (Toner.) 

Few cases. (Berenger-Feraud. loc. cit.,p.l06.> 
117 deaths, Trajis. A. M. A., 1851, p. 207, and 

Drake, p. 197. (Toner.) 
39 deaths, Dowler, N. O. M. J., 1859, p. 597. 

(Toner.) 
Several«cases (Berenger-Feraud, loc. cit., p. 107), 

1 death, Ed. N. Y. J. M., 1856, p. 281. 
'.(Toner.) ■ 
2 deaths. Trans. A, M. A., 1851, p. 207, and 

Drake, p. 107. ■ (T.mer.) 
Berenger-Feraud, loc. cit.. p. 108. 

1 death at MarineHosjdtal, Ed. N.Y. J. M., 1856, 
p. 281. (Toner.) 

18 deaths. Trans. A. M. A., 1851, p. 207, and 

Drake, p. 197. (Toner.) 
2.10 deaths, Trans. A. M. A., 1851, p. 207, and 

Drake, p. 197. (ToTier.) 

2 deaths at Marine Hospital, Ed. N. Y. J. M., 
1856, p. 281. (Toner.) 

95 deaths. Trans. A. M. A., 1851, p. 207, and 

Drake, p, 197. (Toner.) 
49 deaths. Dowler, N. O. M: J., 1859, p. 597. 

(Tpucr.) 



^S 



777 

TaKLE SIIOWINC. YEARS 1\ WHICH YELLOW J EVER HAS IXN'ADED THE SEAUOARH 
CITIES OF THE UNITED STATES, ETC.— Coutinucd. 



V.-;.r. 



Locality, 



Origin 



1834 




is:u 


)■: 


mr, 




183.'> 




is;j(5 




18:;7 


y. 


1837 


E 


1838 


I-: 


183S 




1S:!H 
1838 




1838 




is;;'.) 


y. 


183;> 

183'.) 
] .-3'.» 
183'J 


i: 



Xcw Vnrk. 



r<Mi.s:uola 

Xi;\v Orli'iuis.:.. 



C'li;irlijsl())» .. 
New York... 
NowOiioaii.s. 
do 



■Mobile 

Ciiarl'-ston... 
Xcw Oiloaii.s. 



Mol)ilo 

St- AugUHtiuo. 

Xcw York 

Now Orltuus.. 



(ialvestoii.. . 
IJiloxi, Miss. 
IN'ii.sacoia . . 



1839 



1H3H 
J83'J 



i83'j J-; 



1840 
isiu 



1841 
1811 



ilobilo 

St. Aiigiisliix;. 



'raiMpa 

New VoiIj 



(JliarUstoii 



j New Oil. MILS. 
I Cliarle.-jtoii .. 



NewOili-aiis , 



1841 
1841 

1841 

1841 
1842 

1842 

1842 

1843 

1843 
1843 

1843 
1843 

1844 
1844 

1844 
1844 

IS II 

18 J. 



TMohilr. 

SI. Aiignstiu.5... 



(Jaheston ... 
New Orleans 



Mobile.... 
IVnsacola. 



New York 

New Orleans 



llavano 



New Orleans 



llavyna. 



Now Orleans. 



New Orleans. 



Havana 



Havana... 



Iteniarks. 



Key "SVest 

Cliarl.stoii 

N.-w Orlt.an.s 

Pensaeola 

Mobile 

New Orleans 



Mobile.. 

I'eusaeola ..•. 



Charleston 

New York 



West Indies 



Havana, Yera Cruz. 



IdeatliatT^larine Hospital, Ed. N.Y. J. M., 18GG, 

p. 281. (Toner.) 
Drake, Dis. Int.Valley of N. A., p. 232. (Toner.) 
284 deaths. Trans. A. M. A., p. 207, 1851, and 

Drake, p. 197. (Toner.) 
25 deatiis, Dowler, N. 0. M. J, 1859, p. 597. 

(Toner.) 
2 deaths at Marino Ho.spital, Ed. N. Y. J. M., 

185G, p.281. (Toner.) 
5 deaths, Trans. A. M. A., 1851, p. 207, and 

Drake, p. 197. (Toner.) 
Brought to the city by boats from Havana to 
c New Orleans. Tliore Mere 442 deaths Irotu 
I the disease, Trans. A. ^M. .\., 1851, p. 207, and 
I Drake, p. 197. (Toner.) Carpditer (loe.eit.). 
f The disease was brought by West Indian 

vessels. 
130 deaths, Drake, Dis. Int. Yalley of N. A., p. 

220. (Toner.) 
351 deaths, Dowler, N. O. M. J., 1859, p. 597. 

(Toner.) 
17 deaths. Trans. A. M. A., 1851, p. 207, and 

Drake, p. 197. (Toner.) 
Drake, Dis. Int. Yalley of N. A., p. 191. (Toner.) 
C. C. Dupre, Am. J. Med. Sei., 1841, p. 384. 

(Toner.) 
8 deaths at Marine Hospital, Ed. N. Y.J. M., 

185C, p.284. (Toner.) 
45S deaths. Brought I'rom Havana. (lU-renger- 

Ft-raud, loc. eit:, p. Ill; also Carpenter and 

Tran.s. A.M. A.,1851.) 
250 deaths, Galv. M. J., 1807, p. 8.5(3. (Toner.) 
Drake, Dis. Int. ValKy of N. A., 191. (Toutr.) 
Drake, Dis. Int. Valley ot N. A., p. 233. (Toner.) 
050 deaths, Drake and Brown, Quarantine, 

1872. (Toner.) CarpeiiUr, Inc. cit. 
C. C. Dupre, Am. J. Med. Sei., 1841, i.. 384. 

(loner.) 
Drake, Dis. Int.Valleyof N. A., p. 191. (Toner.) 

4 d.atlis at Marino ilo.spita), Ed- N. Y.J. M., 
1S,'>0, p. 284. (Toner.) 

134 deaths, Dowler, N. O. :\I. J., 1859, p. 5'J7. 

(Toner.) West Indian vessels. (Carj)enler.) 
3d.aths, L"ran.s. A.M.A., 1851.P.207. (Tont-r.) 
22 deaths, Dowler, N. O. M. J., 1859, p. 597. 

(Tcmer.) 
594 death.s, Tran.s. A. M. A., 1851, p. 207. 

(Toner.) Carpenter. 
Drake, Dis. Int. Yalley' of N. A., p. 233. 

(Toner.) 
J. H. L<wis,N.O.M.J., 1844, p. 31. 
20 deaths, C. C. DuprO, Am. J. Med. Sei., 1841, 

p. 384. (Toner.) 
2G deaths, C. C. Dujuv, Am. J. of Med. Sei., 
^ 1841, )). 380. (Toner.) 

Simons Irans. S. C. iU-il. i\ssn., p. 59. (Toner.) 
211 deatlis. Trans. A. .M. A., 1851, p. 207. 

(Toner.) Cari»enler. 
S. C. Laurason, Maryland M.and S.J., 1843, p. 

393. (Tonei.) 
CO deatlis, Drake, p. 222, Brown. Quaianline, 

1872. (Toner.) 
487 deatlis. Tr;ins. A. M. A., 1851, p. 207. 

(Toner.) (."arpenli-r. 
240 deaths, Drake, loc. eit. (Toner.) 
Dr. Wcdderbuin, Kej*. of San. Com., p. 125. 

(Tone I.) 

1 death, Dowhr, N.O.M. J., p. 597. (Toner..) 

5 deaths al Marine Hospital, Ed. N.Y.J. M., 
1850, ]>. 284. (Toner.) 

401) deatlis, Galv. :sr. J., 1807, p. 838. (Toner.) 
14S (teatlis, Tr.uis. A. M. A., 1851, p. 207, and 

Dra!<c. (Toner.) 
Drake.Dis. Int.ValleyofN.A.,p.l91. (Tonor.> 
Dr. Wetlderbiiru, Bep. of San. Com., p. 125. 

(Tuner.) 

2 deatlis at Marine Hospital, Ed. N. Y'.J.M., 
18.".0, ].. 284. (Toner.) 

148 de;iths, Chaillc, Ya. M. J., 185G, p. 499. 
(Toner.) 



78 

Table showing years ix wiiicir yellow eeveii has invaded the seaboard 
CITIES ot-' THE ITjsriTEi) STATES, irrc. — Continued. 



T«!ar. 



3845 

]84f) E 

1846 
1847 E 
1847 



1847 

1847 E 
1847 

1848 E 

1848 E 

1848 

1848 
1848 

1848 

1849 E 

1849 E 

1849 B 

1850 E 

1851 

1851 
1852 E 

1852 

1852 E 
1852 
1852 
1852 

1853 E> 
X8-3 E 



1853 

1853 E 

1853 E 
1853 

1853 E 

1853 
1853 

1853 E 
1853 

1854 E 

1854 



Locality. 



Pensacola — 
New Orleans. 



Pensacola 

Galveston ... 
New Orleans. 



Mobile 

Charles toil... 
. New Orleans. 



^ Savannah 

Charleston 

Norfolk 

rortsnionth, Va. 
New York 



l?iloxi,Mi88.. 

Mobile 

Pensacola ... 
New Orleans. 

Mobile 

Pensacola 



Charleston. 
New York . 



Staten Island, N.Y 
New Orleans 



Mobile.. 
New Ork 



Galveston ... 
New Orleans. 



Biloxi.Miss 

Norfolk 



Mobile.... 
Pensacola 



Key West 



Tampa 

Savannah 



Philadelphia. 
New York . . . 

New Orleans. 



Key West 



Origin. 



Vera Cruz , 



West Indies . 



Wesjt Indies. 



Jlemarks. 



36. 



5>veral cases, lirown^ Quarantine, p. 

(Toner.) 
146 deatlis, Chaill6, Va. M. .7., 1856, p. 400. 

< Toner.) 
Brown, Quarantine, p. 36. (Toner.) 
200 deatlis, Galv. M. J., 1867, p. 838. (Toner.) 
Brou>:lit from Vera Cruz tliis year to New 

Orleans according to Eaget, quoted by B6r- 

enger-Feraud, loc. cit., ]>. 118. There were 

2,259 deaths, Chaille, Va. M. J., 1856, p. 449. 

(Toner.) 
E. 1). Fenner, N. O. M. and S. J.. 1848, p. 1192. 

(Toner.) 
76 deaths, Brown, Quarantine, and Fenner's 

Soiitii. Med. Reports, Vol. II, p. 304. (Toner.) 
Dr. Wedderburn, Hep. of San. Com., p. 125. 

(Toner.) 
850 deaths, Chaill6, Va. M. J., 18.56, p. 499. 

(Toner.) 
75 deaths, Fenner, South. Med. Rep., Vol. II, p. 

304. (Toner.) 
Dr. Wedderburn, Eep. of San. Com., p. 125. 

(Toner.) 
B^rcnger-Feraud, loc. cit., p, 118. 
12 deaths at Marine Hospital, Ed. N.Y. J. M., 

1856, ]). 284, and Trans. A. M. A., Vol. VII, p. 

162. (Toner.) 
l>6rcnger-Feraud, loc. cit., p. 118. 
737 deaths, Chaille, Va. M. J., 1856, p. 499. 

(Toner.) 
50 deaths, Fenner, South. Med, Kop., Vol. II, p. 

304. (Toner.) 
125 deaths, Dowlcr, N. O. M. J., 1859, 

(Toner.) 
102 deaths, Chaille, Va. M. J. 

(Toner.) 
16 d< aths, Chaille, Va. M; J., 

(Toner.) 
Brown, Quarantine, 1872, p. 43. . 
415 deaths, Chaill6, Va. M. J., 1856, p. 499. 

(Toner.) 
10 deaths, R. C. Mackall, Ch. M. J. and Bov., 

1855, p. 150. (Toner.) 

310 deaths. Dowler. N. O. M. J., p. 597. (Toner.) 
Va. M. J„ 1857, p. 95. (Toner.) 
Portsmouth ReliefAs.sn. Report, p. fll. (Toner.) 
1 death at Marine Hospital, Ed. N.Y.J. M., 

1856, p-. 284. (ToneV.) 
536 deaths, Ed; M. and S. Rep., 'VoJ. .YVII, 1867, 



p. 507. 
1850, p. 499. 
1856. p. 499. 



No. 14, p. 297. (Toner.) 
7,9T0 de£ 



deatlis, Chaille, Va. M. T., 1856, p. 499.. 
(Toner.) Many cilfes in Texas and Louis- 
iana were visiU>d by the disease this j'ear. 
According to Fao;et, the disease was brought 
thi.s year by tlie English vessel ('aboden Cas- 
tle from Jamaica. (Bercjigor-F^raud, loc. cit., 
p. 123.) ^ 

J. C. Mott, N. O. M. and S. J., 1854, p. 571. 
(Toner.) 

Infected by a vess^el from the Antilles. There 
were 1,600 deaths. -. 

115 dfaths, N. O. M. and S. J.. 18.54, p. 571. 

E. D. Fenner, History of Yellow Fever, N. 0.» 
1853, p. 49. (Toner.) 

112 deaths. Army Med. Statistics, p. 323. 
(Toner.) 

Army Med. Statistics, p. 323. (Toner.) 

R. C. Mackall, Ch. M. J, and Rev., 1855, p. 150. 
(Toner.) 

128 deaths. W. Jewell, N. Y. J. M.. 1856, pp. 149. 
240, and Brown, Quar.antine, p. 10. (Toner.) 

14 deaths at Marine Ho.ipital, Ed. N. Y'.J.M.. 
18-56. p. 284. (Toner.) 

Tlio disease was carried up the Mississippi 
Valley as far as St. Louis, Mo. (15erenger- 
Feraiid, loc. cit.) 2,423 deatlis, ("hailh-, Va. 
M. J., 1850, p. 499. (T(mer.) 

Ed.N.O.M.andS.J.,1854, p.423. (Toner.) , 



• A widespread epidemic year. 



779 
Taulf- siioaving yf.aus IX wiiicir yr.u.ow- ri:vr,R has ixvaded thi: seatjoap.p 

Cl IIKS OF TIIF UXITFI) S lATKS. FTC— Coiltilllied. 




Pousarola.. 
Charles! on, 
Noriolk.... 
(Jalvestou . 



ri.iladclpliia. 
]S'i;w YorU... 



I'ortsmoiith, Va. 
>.'cvv Urli-aiis 



?C<.rfoll< 
rortsmoutl), V 
New Yorlc.... 
NoAv Orleans.. 



Cliarloslon... 
Bnu.klyn. .. 

Tsfw Uil(;aiis. 



ClmjlcsloTi. 
Galvi-stfMi . 



Pensaoola 

Nt;\v Orleans 



Bilnxi.lliss 

Savannah 

Jioston 



Charleston. 
Mobile....: 
Galvostiin . 

Key "\\"cst ■ 



Charleston 

>.'e\v Orleans...... 

Wihuington, N. C. 



Pensacola 

]S^ew Orleans. 
Oalvestou ... 



St. Thomas 



Havana. 



Key West 

Cliar](;ston 

Newbern, N.C... 



New Orle<ins 

Key West 

Galvestau 

New Orleans 



Havana . 



Havana. 



Pensacola 

Mobile 

Key West 

Galveston 



Baltimore 
Key West 




Cuba 



Ed, Nasli. J. M. nnd S., 1854, p. 34J. (Toner.) 
580 <leatb3, Hume, Cliarleston, M. J., Vol. X, 

p. '61. (Toner.) 
R. B. S. Harris, N. 0. M. N., 1859, p. 727. (Toner.) 
f)27 deaths, Dowler, K. O. M. J., p. 597. (Toner.) 
Va.M.J.,1857,p.95. (Toner.) 
404 deaths, Ed. M. and S. licp.. Vol. 17, 18G7, No. 

14, p. 297. (Toner.) 
Ed. Nash. J. M. and S., 1854. p. 345. (Toner.) 
20deathsat Marine Hosi)ital, Ed.N. Y. J.M., 

185G, p. 284. (ToTier.) 
Portsinoutli KelielAssn.. Pep., p. 91. (Toner.) 
The ilississippi Valley was ajrain infected tiii.H 

year an far north as !Mcmi»his. (Brren^rer- 
'iFeraud, loc. cit.) 2,070 dcatlis, Chaille, Va, 

M. J., 185C., p. 490. (Toner.) 
1,807 deatiis, Portsniontli Pelief Assn., Pejtort. 

(Toner.) Ainer. P. H. A ., ^'ol. I V, p. 280. 
1,000 deatiis, PortsmonthPelicilAssn., Pe]»or(, 

p. 77. Amer. P. U. A ., Vol. IV, ).. 280. 
5 deatiis at Marino Hospital, Ed. N. 1'. J. M., 

1850, p. 28 1. (Toner.) 
74 deatlis, Chaille, Va. ISl. J., 185G, p. 499. 

(Toner.) 
211 deaths, Dowler, N. 0. ^r. J., p. 597. (Toner.). 
;id Nat. Qiiarant. and San. Convention, ]>. 41. 
199 deaths, Chaille, Va. M. J., 1856, ]>. 499. 

(Toner.) 
l.i deaths, Dowlor, N. 0. ]\r. J., p. 597. (Toner.) 
:{44 deaths, Ed. M. and S. Pep., Vol. XVI J, 

1867,No.l4,p.2U7. (Toner.) 
R. B. S. Hargis, N. O. .M. N., 18.59, p. 727. 

(Toner.) . 

Tlie Elisal)eth Helen, contaminated at St. 

Tliopjas,-l)rou£;ht the Aner to New Orleans; 

3,889 deaths Ycdiowed. (UGrenger-Feraud,' 

loc. cit., p. 134; also Ed. J\lcd. Jlep., 1858, Vol. 

I, No. 4, p. 72.) 
S. Cliailh';, Va. M. J.. 1858, p. 77. (Toner.) 
S. Chaill6, Va. M. J., 1858, p. 491 . (Toner.) 
F. E. Oliver, B. M. and S. J., 1858, p. 140. 

(Toner.) 
717 deaths, Dowler, N. O. M. J., p. 597. (Toner.) 
Ed. Va.M. J., 1K58, p. 517. (Toner.) 
180 deatlis, Ed. M. and S- Rep., Vol. XVII, 1867. 

No. 14, p. 297. (Toner.) 
71 deatlis, Ed. M. and 8. Rep., 18G2, p. 513. 

(Toner) A. P. H. A., Vol. IV. 
Brown, '^j.uarantine. ]>. 29. (Ton('r.) 
Fenner, S. J. of M. S.. May, 1800. (Toner.) 
440 deaths, AV. T. AVrage", N. Y. J. M., 1809, p. 

478; A. V. H. A., Vol. IV, and p. 225. (Toner.) 
B. F: Gibbs, Am. J. M. Sol., 1800, ii. 340. (Toner.) 
Chaille, p. 8. (Toner.) 
259 deaths, Ed. M. and S. Rep., Vol. XVII, 18G7. 

No. 14, p. 297. (Toner.) 
E. B. Hunt, Med. Rep., 1864, p. 340. (Toner.) 
Trans. A.M. A., Vol. XXIII, p. 292. (Toner.) 
700 de.aths. Rep. Med. Inspector, U. S. A . ; Dec. 

31,1864. (Toner.) . 
Harris Sanitary Com., p. 264. (Toner.) 
A. P. H. A., Vol. IV, and Br«\vn, (Vnarautino, p. 

40. (Toner.) 
Galv. M.J.,1866. p.338. (Toner ) _ 
The freedom from yellow fever duiin;;' tiic years 

of tho war is accounted for by the bluekadts 
, of tiio city. A fact broaght foiward by Dr. 
. Eormento to prove that the disea.se w.i's not. 

endemic in that city. (Berenser I'V'raiid, loc. 

cit., p. 149.) 3.093 deaths, Ed. N. O.M. J.. 180s, 

p. 194. (Toner.) 
34 deaths. M. Rej*., 1808. p. 227. (Toner.) 
Brown, Qn.arantine, 1872, p. 44. (Toner.) 
Surg. Gen Ts Ollico Circular No. 1, 1868, p.J52. 

(Toner.) 
l,1.50«leaths. S. M.Welch, Gilv. M. J., Vol. I, 

No. 2, p. 83. (Toner.) 
Bcreniier-Ferand, loc. cit., p. 144. and Brown, 

(>u;irantine, i>. 14. (Tonci.)" 
A. P. H. A., Vol. IV i Brown, (,)u.arantine, p. 41. 

(Toner.) 



780 



TaUT.K :^ir(lN\INrr YEAKS IX WHICri Vl-,I.T.O\\- FKAEU HAS TWADEI^ THE oKAUOAllb 
CITIES OF TJIE UnITEI) StATES, E TC— ('oiltilllioa. 



Yei 



0860 
1870 



1870 
J 870 

J87I 

1871 
J 871 

1871 

1872 

1872 
187:3 
1873 

1874 



1874 

187') 
1875 
1875 
1870 

1870 

1870 

1877 
1878 



3878 



Locality. 



New Orloans. 
....du 



Mobile 

Pl.iladclplii;..... 

Cedar Kc\ -^, V\:i 

Tainp.t, I'la , 

Ciiarlc.'.stoii , 

New Orleans 

....do 

New York 

New Orlc.'iDS 

I'oii.'^arol.i. 



.do ... 



Nfw Orleans 

liarram.M.s, l-"ia 

Plis<a-on).l,Miss. 



Oriilin. 



Cuba 

lloudiiraa 



West li.die.s....... 

Havana 

do 

(iciirm ^o.s, Ilnvan.' 



licinniks. 



Vol. XX III, p. 



Havana.. 
do ... 



.do 



Key West .,| { :;8de;itl 



A.l». n. A.,Vol.lV. 

587 doMths, J. (;. Eiijret. N. O. Mod. and S. J., 

Vol. I, No. 2, 187.;. ('lon<r.) Board o 111 oalth. 

La., 1870. 

r>»'Tenf;cr-Ft'-raiid, lor. cH., p. 1 ['>. 

18d< atlis, La Koclio, Yellow Fever, 1870, pp. 20. 

.20. ' i 1 » 

A. 1>. ir. A ..Vol. I V. Med. and S.u- liep., No. 
]7,p.:!77, Vr.l.XXV. (Toner.) 

A. r. U. A., Vol. IV. 
2i:! d.Mtlis, Tnms. .A. M. A. 

2'Xi. (Toner.) 
r.onrd of H.Mltli La., 1871. 5.'. deaf I.h, Km.. 

N.O. r,.olH.J871. (Toner.) 
40 .Ir.iths, Rep. N. O. 15. of U., 1872, i). 17. 

(Toner.) 

B. M. and S. J., Vol. LXXX, No. 23, p. 587. 
• (Toner.) 
L. S. M. H. S. liep., 187.'], 225 deaths; 15. of H. 

La., 187:{; A. P. H. A ., Vol. IV. 
01 deaf lis, K. F. Mi<liHl, Charleston M. J. and 

]l.. lS74,Vol. I,p.28!». (Toner.) A.P. H.A.. 

Vol. IV: J. M. Woodwortb, U. S. M. H. S. 

Kei...l87:!. 
Tho citv was infeeied through the Castropoe 

from Ilavjin.i. (Ucp. U. S. "Mod. Com., U. S. 

M. H.S Ke,,.,1874; A. P. H. A., Vol. IV.) 
P. of If. La., 1874. 
U. S.M. U.S. Kep., 1875. 
' r. S. :\L II. S. Lep.. 1875, 00 deaths. 



Lriujswick j ll;ivana 

Dobov, (Ja :. 

! 
I .S;ivai)iiah ;. 



Fern.Hiilin:i 

Memi'liis .-ind :.1I IIh^ 
^Ij.-.si.ssijipi X'allry 
. toC.'iirn, 111. 
New Orleans 



s. (U.S. M. U.S. Kep,,1875.) 



1878 
1879 


1880 
1882 
1882 
18K2 E 
18h:! K 
1883 


1884 
1887 E 



1887 
1888 

1888 
1890 
189;i 

1893 



New York . . . 

New Orleans. 



Key "West 

(;..iv.ston 

Nfw OiliMiis 

Ibcwton. Ala .. 
Peus;H'.»l;i , 



Peu.';ae,ola (?)... 
Key W^ist 



T.impa, Fla 

Jacksonville, Fla 



Tampa. Fla 

P>rn>i8wiek, Ga 

Brunswick, Ga., and 

adjjieont islan«is. 
Satiila Kiver, Ga 



...do .... 



West Indies 



llavi.n:. 

Malanzas 

Ptnsa.ola 

Havana 



IIa^ an£ 



do 

do 



I 112 deatli.s. (Smith in tho L'. S. M. H. S. 
I P.'p.s., 1870-77, p. 185. 
A. P. IL A., Vol. IV, J.. 2r.I, and U. S. M. K 

S. Re]. .,1870 77. 
F.S.M.H. S. Kep., 1870-77, p. 180, A. P. n. 

A., Vul.IV,251. 
A.r.n.A.,Vol.IV. 



A. P. IT. A.. Vol. TV, and Sternberg. Tho 
.steamer liimily Soiidtr brought (he di^^ea8e 
to tho city from tho Antilh'S. (Bi-renger- 
Ft'raud, loc (it.) A severe epidemic year. 
There were in the United States 125,000 cases 
Jind 12,000 (leaths. (N. V. Med. R., Dec, 1878; 
I5t';renger-Frrand, loc. eit.. p. 152). 

Btfrenuer-FOraiid, loc.cit., p. 152. 

Thp disense extended along the Mississippi as 
I'aras Memphis. Thedi.seasewasbroughtfroni 
the Antilles to New Orleans by the Plymouth. 
(Med. Rep. U.S. Nayy, 1879, Dr. Woohorton.) 



National B. of IT. Rep , 1882. 
U. S. ^l II. S. Rep., 1883, 192 deaths'. 
M. U.S. Rep., 1884. 
Sporadic cases, but there was an epidemic at 

tlie navv-yiird, 9 miles from Pensacola. (M. 

ILS.Rep.';i884, p. 200.) 

Abstract of S.an. Rep., TT, S. M. H. S., 1887, and 
U. S. M. U.S. Re).., pp. 12, 13. 1887; 280 cases 
and 02 deaths njt to 8(;ptember. 

U. S. iM. II. S, Rep., 1887-88. 

Plant City and neighboring cities. U. S. M. H. 
S. Rei».,18b8. 

Probably from Tampa epidemic of 1887. 

52 deaths. Abstr.aet of San. Rep., 1894, p. 81; 
U. S. M. H. S. Rop., 1«93. 
Do. 



ALABAMA. 

Summary of Yellow Fever in Alabama^ by Localities. 

ALCO. 

1897. Cases, 1; death, 0. 

ATHENS. 

1878. Cases, 2; deaths, 2. 

BAY MINETTE. 

1897. Cases, 1; deaths, 1. 

BLADEN SPKINGS. 

1853. Sporadic cases, solely among refugees. 

BLAKELY. 

1822. Severe epidemic. No statistics. 

BEEWTON. 

1883. First case, September 12; first death, September 
19. Last case, November 6. Cases, 70; deaths, 28. 

CAHAWBA. 

1853. No record of cases and deaths. 

castlebeeky. 

1905. Cases, 2; deaths, 2. 

CITEONELLE. 
1853. No record of cases and death j^. 



782 HISTORY OF YELLOW FEVER. 

GOUKTLAXD. 

1878. Infected by Memphis. Cases, 1; deaths, 1. 
DEGATUE. 

1878. Population, 1,200. Cases, 187; deaths, 51. 

1888. First case, September 4th; first death, Septem- 
ber 11. Cases, 10; deaths, 1. At the beginning of the 
outbreak, nearly the whole population fled. 

DEMOPOLIS. 

1853. Xo record of cases and deaths. 

DOG RIVEE. 

1853. Population, 300. First case, August ISth ; first 
death, August 22nd. Cases, 69 ; deaths, 2^3. 

FLOMATOX. 

1897. Cases, 98; deaths, 5. 

FLOEEXCE. 

1878. Population, 2,500. Cases, 1,109; deaths, 50. 

FOET CLAIBOEXE. 

1819. First case, July 4; last case, December 1. Xo 
statistics. 

FOET BAYOX. 

1893. First case, July 30; first death, August 3; last 
drath, Xcvember 16. Case§, 6; deaths, 5. 

FOET MOEGAX. 

1867. First case, August 13. Xo statistics. 
1893. Cases, 2 ; deaths, 1. 



ALABAMA. 78S 

FORT ST. STEPHEN. 

1819. First case, July 4 ; last case, December 1. 

FULTON. 

1853. No record of cases and deaths. 

GREENSBORO. 

1897. Cases, 1; deaths, 1. 

HOLLY WOOD. 

1853. Infected by New Orleans. First case, Aujo'iist 
15th ; first death, August 29th. Last case, September 20th. 
Cases, 10; deaths, 6. 

HUNTSVILLE. 

1873. Cases, 3; deaths, 1. 

1878. Cases, 33; deaths, 13. All imported cases. 

JUNCTION. 

1873. Population, 35. Cases, 22; death\^, 14. 

LEIGHTON, 

1878. First case, August 18; first deatli, August 24. 
Cases, 4; deaths, 1. 

MOBILE. 

1705. Several historians state that yellow fcA^er made 
^V-T^^^it havoc'' in Mobile in 1705. No statistics are given. 

1765. Epidemic. No record of cases and deaths. 

1766. Severe epidemic. Yerj fatal among new comers. 
1819. Population, 1,200. Numer who fled, 300. First 

case, August 19 ; last case in November. On October 22, 
there was a light frost, but the disease continued un- 



784 HISTORY OF YELLOW FEVER. 

abated until the end of Xovember. Many persons were 
lured to the city by the frost and fell victims to the fever. 

1821. Sporadic cases; 7 deaths in October. 

1822. ''Only 1 or 5 cases." 

1821. Six fatal cases in September; last case on the 
25th, notwithstanding that there was no frost until the 
latter part of October. 

1825. Severe epidemic. The Board of Health con- 
cealed the real state of things from the public, and al- 
though yellow fever had made its appearance as early as 
Jul 3^, official announcement was made on August 10, 
''that though the bilious fever prevails to considerable ex- 
tent, and in many instances fatal, yet the Board takes 
pleasure in assuring the public that no case of yellow 
fever has yet occurred." It was only on September 2, 
after the disease had become epidemic, that "one case 
of yellow fever" was reported. Three cases were reported 
on the 5th, four cases on the 8th, and on the 11th ot 
Sei^tember, the "painful announcement that the disease 
is epidemic- was made. As no true statistics were kept, 
it is impossible to give the number of cases and deaths. 

1826. SiDoradic cases in September. 

1827. A few cases in September. 

1828. Mild epidemic. No statistics. 

1829. Population, 4,000. Epidemic. First case, August 
14. Deaths, 130. 

1837. For eight years. Mobile was free from epidemic 
disease. On September 20, 1837, four cases of yellow 
fever suddenly made their appearance. After this out- 
break the disease disappeared, and the public mind was 
reassured. There was a light frost on October 2, and 
those who had fled returned to the city, feeling certain 
that all danger was over. On October 10, cases erupted 
in nearly every section of the town, and the disease was 
soon epidemic, running its course until the end of Novem- 
ber. Deaths, 350. 

1838. Sporadic cases. No statistics. 

1839. Population, 11,000. The new population was 
composed chiefly of people from the North, and German 



ALABAMA MOBILE. 785 

and Irish laborers. The first case of ^^ellow fever occurred 
on August 11. In ten days the disease became general 
throughout the city. Last case, October 20. Deaths, 450. 

1841. Scattered cases. The subjects were from the 
interior, no inhabitant of Mobile being affected. 

1842. First case, August 20. Limited manifestation 
confined to the southern section of the city. Cases, 160; 
deaths, 70. 

1843. Population, 11,500. The first case of the epi- 
demic of 1843 occurred on August 24, folloAved by a sec- 
ond case on the 26 ; both terminated fatally. It was not 
generally known that the disease had broken out, the 
public being kept in ignorance of the fact. About Sep- 
tember 10, many cases, accompanied by black yomit, were 
observed, and the disease soon became widespread. Last 
case erupted November 5. Cases, 1,350; deaths, 750. 

1844. First case, August 14. Deaths, 40. 

1845. Population, 12,000. First case, November 9. 
Deaths, 1. 

1846. First case, September 11. Deaths, 4. 

1847. First case, August 2. Deaths, 78. 

1848. First case, August 18. Deaths, 24. 

1849. First case, July 3. Deaths, 21. 
1851. Mild outbreak. No statistics. 

1853. Population 25,000. Number who fled, 8,000. 
Infected by bark MiUiades. from New Orleans. First 
case, July 11; first death, July 11. Last case, December 
16. Deaths, 1,191. There were many cases among the 
negro population, but only 50 died. 

1854. Sporadic cases. 

1858. First case, August 3; first death August 13. 
Deaths, 70. 

1863. Sporadic cases, one imported from Key West; 
two deaths. 

1864. Sporadic cases; six deaths. 
1867. First case, August 13. 

1870. First case, August 27 ; last case, November 19. 



786 HISTORY OF YELLOW L?:VER. 

1873. Infected by Xew Orleans. First case, August 
21 ; first death, August 26 ; last case, XoYember 29. Cases, 
50; deaths, 27. 

1875. First case, September 1; first death, September 
7; last case, October 20; last death, October 21. Cases, 
16; deaths, 8. 

1876. First case (reftigee from Xew Orleans ), Septem- 
ber 5, terminating in death on the 9th; last case (refugee 
from Savannah I in December; recovereel. Both cases at 
Battle House. 

1878. Population, 31,031. The first case was a negro 
who had been on an exctirsion to Biloxi, Miss., July 24, 
was attacked early in August and died Atigust 16. The 
health officer certified to the Board of Trade, August 19, 
that ''there was not a case of yellow fever in the city or- 
country," and Montgomery raised the quarantine she had 
against Mobile. From August 16 to September 21, there 
were only 5 deaths, but early in October, deaths began 
increasing; B. B. Fort, of the Board of Trade dying 
October 11, at Spring Hill. A majority of the cases were 
in the extreme southern portion of the city. A slight 
frost fell in the suburbs, October 23, on which day there 
were reported 3 deaths, 5 new cases, and 11 tinder treat- 
ment ; Father Victor, of the Lutheran Church, was among 
the deaths. The death rate decreased till October 31, at 
which date no deaths were reported. Last death, October 
30. 

Total cases, 297; total deaths, 83. 

1880. One case, on board British bark R. W. Wood, 
from Havana. Xo cases in city. 

1897. Infected by Ocean Springs, Miss. Cases, 361; 
deaths, 18. 

1903. Cases, 1; deaths, 1. 

1905. July 21. Four cases at Quarantine Station, on 
board steamship Colomhia, from Colon and LaBcca. Xo 
cases in citv. 



ALABAMA. 787 

MONTGOMERY. 

1853. First case, September — ; last case, November 
— . deaths, 35. 

1854. First case, September — ; last case, November 
— . Deaths, 45. 

1855. First case, September — ; last case, November 
— . Deaths, 30. 

1867. First case, August 13. Sporadic cases. Im- 
ported. 

1870. First case, August 22; last case, November 19, 
Sporadic cases. 

1873. Infected bj Pensacola. First case, August 27; 
first death, August 27; last case, November 10. Cases, 
500 ; deaths, 108. Whole population fled, except 1,800. 

1897. First case, October 18; last case, November 10. 
Cases, 120 ; deaths, 11. 

1905. One case, a refugee 

NOTSALUGA. 

1897. Cases, 1 ; deaths, 0. 

OAKFIELD. 

1873. First case, September 22. Cases. 7; deaths, 1. 

POLLAED. 

1873. Sporadic cases. No statistics. 

POETEKVILLE. 

1853. Cases, 5; deaths, 2. All refugees from infected 
jjlaces. No case among inhabitants. 

SELMA. 

1853. Population, 3,000. Number who fled, 1,500. 



788 FIISTORY OF YELLOW FEYEA. 

First case, September 1; first death, September 1; last 
death, Xovember 13. Deaths, 32. 

1897. First case, October 23 ; last, October 31. Cases, 
12; deaths, 2. 

SAXDY EIDGE. 
1897. Cases, 1; deaths, 0. 

SPEIXG HILL. 

1853. As Yellow fever has been ej)idemic only once 
in this beautiful place, the following account, summarized 
from the memoirs of Dr. J. C. Xott, who came so near 
expounding the mosquito doctrine of the transmission of 
yellow fever, over half a century ago, will be found 
interesting : 

On the 12th of August, just about the time yellow fever 
began to assume the epidemic form in ^Mobile, and one 
month after the first imported case. Dr. Xott was called 
to see a young man, who had a well-marked attack of 
the disease, at a boarding house in Mobile, on St. Louis 
Street, -near St. Joseph. On the 11th, the patient was 
removed on a stretcher to the Louse of his brother-in-law, 
in Spring Hill, about the center of the settlement. He 
recovered, and twenty days after he had entered the 
house, otli of September, two children living there were 
attacked with the fever, and about two weeks after, two 
other children were attacked; three had black vomit and 
two died. 

On August 22, a 3Ir. Stramler, of Mobile, moved his 
family to Spring Hill and occupied the house of John 
Toulmin. 

Mr. Greer moved with his family to the same house on 
the 29th, from Mobile, carrying a daughter convalescing 
from yellow fever ; another daughter sickened on the 8th ; 
three of Mrs. Flemming's children in the same house, on 
the 10th ; and Mrs. John Greer two or three days after. 

Dr. Xott's father-in-law, Col. Deas, lived on a lot about 
10 yards north of the original source of infection, and his 



AiABAMA 789 

liouseliold, white and black, consisted of sixt^^ persons. 
On the 7th of September, one of his negro women were 
attacked, on an adjoining lot; on the 8th, his claughter- 
in-laAv, Mrs. John Deas, and on the 9th, Mrs. Brown, his 
daughter; each being in a different lot, and one hundred 
yards from each other. The disease then spread rapidly 
through the families of the three adjoining premises, at- 
tacking whites and blacks indiscriminately. Fifty- four 
were attacked out of the sixty, and in fourteen days the 
whole tale was tolel — five whites, two mulattoes and one 
black we^re dead with black vomit, and the rest were con- 
valescent. One-half of the whites attacked died. 

Cases existed simultaneously at Wm. Stewart's, Mr. 
Wheeler's, and Mr. Purvis' and Toulmin's houses, widely 
separated from each other ; and in the latter part of Sep- 
tember and through October, the elisease visited the houses 
of Capt. Stein, McMillan, Rev. Mr. Knapp, Mrs. George, 
Dubose's, John Battle's and some others. The disease 
skipped about in an extraordinary manner; some houses 
escaped entirely, some had but one or two cases. 

Dr. Nott fails to give the' number of cases and deaths. 

1878. One death, October 14, a refugee from Mobile. 
]^s'o cases in the village. 

steye:s^son. 

1878. Population, 200. Probably infected by Mem- 
phis. First case, September 1. Ca^s, 11; deaths, 0. 

ST STEPHEN'S ROAD. 
1853. First case, August 23. Infected by Mobile. 

TOWN CREEK. 

1878. Population, 75. Deaths, 4. 
TUSCALOOSA. 

1878. Cases, 2 ; deaths, 2. 



790 HISTORY OF YELLOW FEVER. 

TUSCUMBIA. 

1878. Population, 1,200. Infected bj Memphis. First 
case, September 5. Cases, 97; deaths, 31. 

WAGAE. 

1897. Cases, 45; deaths, 3. 

WHISTLEE. 

1878. A few cases among refugees; inhabitants not 
attacked. One death only, Father Marley, of Mobile, 
occurred on October 18. 

1897. Cases, 122; deaths, 7. 

WHITIXG. 

1870. Sporadic cases ; refugees. 
1875. Cases among refugees. 

BIBLIOGRAPHY OF YELLOW FEVER IN ALABAMA. 

Anderson (W. H.) : Report on the Diseases of Mobile in 1S53. Trans- 
actions of the Medical Association of the State of Alabama. 8vo. 
Mobile, 1854. 

Cochran (J.) Contributions to the Transactions of the Medical As- 
sociation of the State of Alabama, session of 1874. I. The 3'ellow fever 
epidemic of 1873. 8°. Montgomery', 1874. 

Cochran (J.) : The Outbreak of Yellow Fever at Brewton in 1883. 
Tr.. Med. Assn. Ala., Montgomery, 1884, vol. 36, p. 170. Also: Rep. 
Bd. Health Ala., 1883-4, Montgomerj', 1885, p. 47. 

Forest (W. E.) : The cost of Yellow^ Fever Epidemics; the Epidemic 
at Decatur, Ala., in 1888. Med. Rec, N. Y., 1889, vol. 35, p. 620. 

Gilmore (J, T.) : An Account of Yellow Fever as it Prevailed in 
Mobile and Vicinity in 1873. Reports Am. Pub. Health Assn., 1873, 
vol. 1, p. 393. 

Glennan (A. H.) : Report of the Operations of the Service in Ala- 
bama during the Epidemic of Yellow Fever in 1897. Rep. Superv. 
Surg. Gen. Mar. Hosp. 1896-7, Wash., 1899, p. 649. 

Lfewis (P. H.): Medical History of Alabama. New Orleans Medical 
and Surgical Journal, iii. 691; iv. 3, 151, 318, 459. 



ALABAMA 791 

Lewis (P. H.): Sketch of the Yellow Fever in Mobile, with a brief 
Analysis of the Epidemic of 1843, etc. N. O. Med. & Sur„ Jl., vol. 1, 
pp. 281, 413. 

Marks (J. C.) : Yellow Fever of Selma, Alabama, in 1853. Transac- 
tions of the Medical Association of the State of Alabama. Mobile, 1854. 

Michel (R. F.): Epidemic yellow fever in Montgomery, Ala., during 
the summer of 1873. Charleston M, J. & Rev., 1873-4, vol. 1, pp. 289- 
305. Also: Reprint. 

Michel (R. F.) : Epidemic of yellow fever in Montgomery, Ala., sum- 
mer of 1873. Tr. M. Assn. Alabama, Montgomery, 1874, p. 87. Also, 
Reprint. 

Nott (J. C.) : Sketch of the Epidemic of Yellow Fever in 1847, in 
Mobile. Charleston Med. Jl., vol. 3, p. 1. 

Nott (J. C.) : The Epidemic Yellow Fever of Mobile in 1853, com- 
municated with the Sanitary Commission of N. O. N. O. Med. and 
Surg. Jl., 1853-4, vol. 10, p. 571. 

Report of the committee appointed to investigate the causes and 
extent of the late extraordinary sickness and mortality in the town 
of Mobile. 8°. Philadelphia, 1820. Also, in: Med. Reposit, N. Y., 
1820, vol. 20, pp. 333-344. 

Riggs (B. H.) : The history of the yellow fever epidemic in Selma 
in 1853. Tr. M. Assn. Alabama, Montgomery, 1882, p. 400. 

Boling (W. M.) : Yellow fever in Alabama. N. O. M. & S. Jl., 1853-4, 
vol. 10, p. 409. 

Stone (G. H. & Carson (W. H.) : Epidemic of Yellow Fever at Brew- 
ton, Ala., Rep. Superv. Surg.-Gen. Mar. Hosp., Wash,, 1883-4, p. 223. 

Wahly: On the Treatment of Yellow Fever as it occurred in Mobile 
in the fall of 1853. New Orleans Medical and Surg'ical Journal, vol. 
11, 1854-5, p. 289. 

Wilkinson (J. A.) : A sketch of yellow fever at Whiting in 1870, and 
1873. Tr. M„ Assn., Ala., Montgomery, 1883, p. 175. Also: Rep. Bd. 
Health, Ala., 1883-4, Montgomery, 1885, p. 120. 



ARKANSAS. 

AUGUSTA. 

1878. Population, 1,200. Infected by steamboat Buth, 
from Memphis. First case, October 12, followed bj death 
two days later ; last case, October 20. Cases, 7 ; death, 7. 

COLUMBIA. 

1853. Infected by steamboat J. J/. Beff, from New 
Orleans, in June. Patient was an Irishman who developed 
the disease on board, and was left at a woodvard just 
above the town. He died with black vomit, but did not 
communicate the disease to any one. Six other cases were 
put off different steamboats at Coltimbia in Jtily. The 
H. D. Bacon stopped at this place about September 1, 
having 20 cases of yellow fever on board. The captain 
and chambermaid were attacked while the boat was at the 
landing, and both died shortly after her departtire. Fen- 
ner (Epidemics, etc., p. 107), says that ''nearly every boat 
from ]N^ew Orleans'' which stopped at Columbia dtiring 
the terrible epidemic of 1853, had yellow fever on board. 
The people of the town visited the boats, btit no one catight 
the disease. 

FOEEST CITY. 

1873. Two cases, refugees from Memphis. 

1879. Infected by Memphis. First case, October 2: 
first death, October 8 ; last case, November 25 ; last death, 
Xovember 2S. Cases, 23; deaths, 15. 

FOKT SMITH. 

1823. Imported cases; no statistics. 
GOLDEX LAKE. 
1878. Three cases, reftigees from New Oilcans. 



ARKANSAS. 793 

GllAND LAKE. 

1853. Infected by steamboat Bunl:cr Hill, from NeAV 
Orleans. First case, August 24, in a man who had taken 
passage on the boat at Natchez, Miss. Patient died on 
the 24th. Three residents of Grand Lake, who visited 
the boat, were attacked, but recovered. There was no 
spread of the disease. 

HAYNES BLUFF. 

1878. Cases, 160; deaths, 19. 

HELENA. 

1878. Infected hj Memphis. First case, Angust 17; 
first death, August 21. Cases, 77; deaths, 9. 

HOPEFIELD. 

1878. Infected b}^ Memphis on September 1 ; hist death, 
October 23. Cases, 117; deaths, 7. These figures also 
include the immediate vicinity. 

1879. Two cases, about a mile from Ilopefield. No 
cases in town. 

LITTLE EOCK. 

1878. A little boy, a refugee from Memphis, who died 
shortly after his arrival, is the only case of yellow fever 
ever observed at Little Eock. Shot-gun quarantine was 
in full force. 

■ LOEENZO. 
1878. Cases, 1; deaths, 1. 

NAPOLEON. 
1853. Severe outbreak. No statistics. 



794 HISFORY OF YELLOW FEYER. 

OCEOLA. 

1873. Infected bj New Orleans. First case, August 
— ; first death, August 11; last case, Alugust — ; last 
death, August 11. Cases, 1 ; deaths, 1. . 

SCANLOInS. 

1878. Cases, 1. 

TEEKENE. 

1878. Cases, 21; deaths, 19. 

WASHIXGTON. 

1878. One case from Humboldt, Ark. ; death, 

BIBLIOGRAPHY OF YELLOW FEVER IN ARKANSAS. 

Cummings : An Account of the Yellow Fever as it Appeared at Forest 
City, Arkansas, during the Summer of 1879. Trans. CNIed. Society of 
Arkansas, 1880, vol. 5, p. 45. 

Cummings: National Board of Health Bulletin, 1879-80, vol. 1, pp. 
137; 145; 149; 161; 178; 202; 216; 289. 

Dowler: Yellow Fever, p, 24. 

Erkskine: Trans. Am. Pub. Health Assn., 1873, vol. 1, p. 385. 

Fenner: History of Epidemic Diseases, 1853, pp. 49; 106. 

Fenner: Trans. Am. Med. Assn., 1854, p. 526. 

Jones: N.. O. Med. & Surg. Jl., 18534, vol. 10, p. 328. 

Keating: History of Yellow Fever, pp. 92; 94; 96; 250. 

National Board of Health Bulletin, 1879-80, vol. 1, pp. 117; 145. 

Report Sanitary Commission of New Orleans, 1878, 

Washington Republican, vol. 12, No. 260, p. 1. 



CALIFORNIA. 

The only cases of yellow fever ever observed in the State 
of California, were taken off vessels from Sonth American 
or Mexican ports, and treated at the San Francisco Quar- 
antine Station. The disease has never spread to the 
inhabitants. 

Yellow Fever Years. 

1883. According to Nelson (see Bibliography) Le 
Courrler de ^San Francisco published an account of a 
jury sitting on a body in that city, to determine the exact 
cause of death. While taking the evidence, it was shown 
that the dead man and another sick passenger had been 
landed from a steamship from the Pacific Coast of Mex- 
ico, and that the corpse before them was that of a victim 
of yellow fever. The Courrier graphically describes how 
that jury stampeded at the startling revelation. It was 
a regular sauve qui petit. 

1894. On August 23, the steamship Bennington, from 
La Union and other ports on the coast of Salvador, 
arrived at San Francisco and landed three cases of yellow 
fever. No further information. 

1897. May 10, steamship "sent cases ashore." No his- 
tory of subsequent developments. During the year, the 
following infected vessels, all from' Panama, were de- 
tained for observation: Acapulco, San Juan and dtp of 
Sydney. All these vessels had heavy passenger lists, but 
no cases erupted at San Francisco. 

June 2. City of Para, from Panama, infected with 
yellow fever, entered harbor. One case died as the vessel 
steamed into port. No developments. 

July 11, the steamship arrived from San Juan de 
Guatemala. One case upon arrival. No further history. 

1898. One case at Angel Island Quarantine Station, 
taken, from steamship Neicport, from Panama. Death 
on arrival. 



79G HISTORY OF YELLOW FEVER. 

1902. Ma,y 20, City of Fara arrived from Panama and 
was remanded for disinfection, owing to rumors of yellow 
fever on board. Three days later, the freight clerk ^( who 
had been ashore) had an attack and died May 2^. No 
other cases reported. 

1903. September 10, steamship Colon, from Panama, 
arrived in port with a case of yellow fever on board. 
Patient was immediately removed to Angel Island Quar- 
antine Station, where he died the following day. 

The case was certainly an interesting one from a quar- 
antine standpoint. Patient was a strong, lithe man; 
age given upon articles, 23 years (probably 28 or 30) ; 
native of Chili. He shipped at Acapulco upon the down 
voyage. Was ashore at Panama, but at no port upon the 
up trip. Vessel loaded in open water from lighters at all 
ports en route. Fifteen days from Panama, in the early 
morning, the man reported to the ship's surgeon with 
headache, pains in back over liver and down right 
shoulder. History of chill during night or early morn- 
ing; no history of malaria; pulse 65; temperature 
40° (102°) ; ajJpearance of slight icterus, which rapidly 
increased. 

No written history kept nor examination of urine or 
blood made. Diagnosis of obstruction to bile duct. No 
vomiting noted. 

When seen by Passed Assistant Surgeon Gumming, 
from whose report this history is summarized, the man 
had just been brought from the forecastle in the gang- 
way in the cold wind. He was semi-conscious, respond- 
ing to loud inquiry as to whether he wanted water. Body 
bronze yellow; eyes ver}^ yellow; tongue not enlarged, 
pointed, red around edge, seme sores; left parotid gland 
enlarged and tender; some shrinking on pressure in epi- 
gastric region; spleen and liver not enlarged (percussion 
and palpation). Some blood signs on blanket, but pos- 
sibly due to ulcer on left elbow. 

After having been removed, catheterization brought 235 
c.c. of urine highly colored, slightly cloudy. Specinc 
gravity, 1010. Peaction, acid. Albumin in large quan- 



CALIFORNIA. 797 

titles l)Y all tests used. Examination of blood for malaria 
by several offieers, negative. Pus in parotid gland, ordi- 
nary diploeocci. 

Patient greAv worse, during night had classical black 
vomit, died next day. Autopsy confirmed diagnosis. 
Cremated. 

The interesting features from a sanitary point are: 
First attack fifteen days from the only place reported 
infected (Panama), and about three days after leaving 
Acapulco. The vessel was thoroughly searched by Sur- 
geon Cumming, other officers, and attendants for mos- 
quitoes, dead or alive, and not one was found, despite a 
considerable reward offered. 

The original source of infection was evidently Panama. 

BIBLIOGRAPHY OF YELLOW FEVER IN CALIFORNIA. 

Berengsr-Feraud: Fievre Jaune, etc., Paris, 1890, p. 189. 

Ball3^: Typhus d'Ameriqiie ou Fievre Jaune, p. 39,. 

Comming (H. S.) : History cf yellow fever case on steamship Colon, 
at San Francisco Quarantine, from Panama; yellow fever on vessels 
in previous years. Pub. Health Rep. U. S. Mar. Hops. Serv., Wash., 
1903, vol. 18, p. 1631. 

Lind: Diseases Incidental to Seamen in Hot Countries, vol, 1, p. 39. 

Medical News, N. Y., 1883, vcl. 43, p. 420. 

Nelson (W.) : Yellow Fever Considered in its Relation to the State 
of California. Rep. Bd. Health Calif. Sacramento, 1884-6, vol. 9, p.. 220. 

Perry (A. W.) : Yellow Fever at San Francisco, Western Lancet, 
San Francisco, 1883, vol. 12, p. 389. 

U. S. Public Health Reports, 1897, pp. 563, 607, 685. 

Ibid., 1898, p. 634. 

Ibid., 1902, p. 1172. 

Ibid,, 1903, pp. 1540; 2298. 



CONNECTICUT. 

CHATHAM. 

179G. First case, August 29. Infected by brig Polly, 
from San Domingo, West Indies. Xo record of cases and 
deaths. 

HARTFOED. 

1798. Sporadic cases, imported. Xo statistics. 

1800. Old chroniclers sav that rellow fever was im- 
ported to Hartford in 1800, and ''created much alarm and 
raged for a time with considerable mortality." Xo 
statistics. 

KXOWLES LAXDIXG. 

1796. First case, August. Deaths, 9. 

MIDDLETOWX. 

1820. First case in June. Infected by schooner MUo, 
from West Indies. 

XEW HAVEX. 

1735 ; 1713 ; 1791 : 1803 ; 1801 ; 1805 ; 1819 ; 1815. Yel- 
low fever was imported to Xew Haven in the years men- 
tioned, but no reliable statistics could be obtained. 

XEW LOXDOX. 

1798. Source of infection not stated, writers of the 
period attributing the outbreak to "a lot dried fish, which 
had decomposeel and exposed on the public wharves." 
First case, August 25 ; last case, October 28. Deaths, 81. 

XCRWALK. 

1798. Mild outbreak. Xo statistics. 



CONNECTICUT. 799 

NOEWICH. 
1801. Importation. No record of cases and deaths. 

STANFORD. 
1715. Mild outbreali ; no statistics. 
STONINGTON. 
1798. Mild outbreak; no record of cases and deaths. 

BIBLIOGRAPHY OF YELLOW FEVER IN CONNECTICUT. 

Bancroft: Essay on Yellow Fever, p. 399. 

Beck (J. B.) : Communications concerning the yellow fever at 
Middletown (Conn.) In: Hosack (D.) : Observations on febrile conta- 
gion, (etc.). 8°. N. Y., 1820, p. 53. 

Channing: An Account cf the Pestilential Disease which prevailed 
at New London in the summer and autumn of 1798. New York Medical 
Repository, vol. 2, pp.. 402-405. 

Coit (T.) : Additional account of the p.eotilential fever which pre- 
vailed at New London, Conn., (1799). Ibid., 407. 

Holt (C): A short account of the yellow fever, as it appeared in 
New-London in August, September and October, 1798; with an accurate 
list of those who died of the disease, the donations, etc. 8°. New- 
London, 1798. 

Medical Repository, 1805, vol. 3, p. 292. 

iMonson (Sen'r.): Letter on the Treatment pursued, and most suc- 
cessful in the cure of the Yellow Fever in New Haven in 1794. 
Webster's Collecticn, p. 184,. 

Monson (Jun'r.) : Letter on the Origin, Symptoms, Progress, etc., 
of the Yellow Fever in New Haven in 1794. Webster's Collection, p. 
173, etc. 

Scott (Charles): Short Account of the Yellow Fever, as it appeared 
in New London in 1798. New London, 1798. 

Strobel: p. 101. 

Tully: Yellow Fever of Middletown in 1820, and Chatham and its 
Neighborhood in 1796. Essays on Fevers and other Subjects, by 
Thomas Miner and William Tully. 8vo. 1823. 

Tully (W.) : History cf the yellow fever as it occurred at Knowles 
Landing, Conn. N. Y. M. & Phys. J., 1822, vol. 1, pp. 153-158. 

Tully (W.) : History of the peculiar fever that occurred at Middle- 



800 HISTORY OF YELLOW FEVER. 

town. Connecricut. during ihe months of June and July, 1820; yellow 
fever in Chatham, in 1796, and its origin. In Miner (T.) & Tully (W.) 
Essays on fevers and otier medical subjects, Middletown, 1823, pp. 
291-403. 

Tully (W.) : Observations on yellow fever, with cases which oc- 
curred at Middletown and Chatham, in Connecticut, Virginia M. J., 
Richmond. 1856, vol. 7, pp. 439-459. 



DELAWARE. 

CHEISTIANA. 

1798. InfectcHl by Wilmington, Delaware. No stat- 
istics. 

DE LA WAKE BREAKWATER. 

Yellow fever cases were brought to Lewes (Delaw^are 
Breakwater Quarantine Station) by ships from the West 
Indies in the following years : 

1878. Many cases Avere landed from ships. Deaths, 9, 
of which 7 were sailors. 

1887. August 8, bark Ada Gray, from Havana. One 
case; recovery. 

1888. Brig Teneriffe, from Havana. First case, July 
22; first death, July 27; last case, July 23; last death, 
July 27. Cases, 3; deaths, 2., 

1889. June 9. Steamship Baltimore City, from San- 
tiago de Cuba. Two cases. 

1892. During 1892, the following infected vessels were 
detained at this station : 

May 10. Norwegian bark Nor, from Rio de Janeiro. 
Nine cases and two deaths at Rio and during passage. 

June 1. British bark WilloKy Bush, from Rio de 
Janeiro. Had several cases at Rio and one death during 
voyage. 

June 6. British ship Elmhank from Rio de Janeiro. 
Several cases during voyage. 

June 28. German ship Rudolph von Benninger, from 
de Janeiro, via Barbados. Eleven cases and five deaths 
while at Rio. 

July 25. British bark Argcnta, from Pernambuco, via 
Santos. Several cases and one death after leaving Santos. 

August 3. British barkentine Frederica, from Santos, 
via Guantanamo. Several cases during voyage. 

It will thus be seen that six vessels, actually infected 
with yellow fever, reached Delaware Breakwater Quar- 



802 HISTORY OF YELLOW FEVER. 

antine during 1892. While no cases erupted during their 
detention, there is no telling what might have been the 
consequences if rigorous sanitary precautions had not 
been taken. While the Stegomyia Calopus no longer 
thrives in the locality, the epidemic which ravaged certain 
sections of Delaware a hundred years or so ago, prove 
that the insects, when imported during the summer 
months, can be domesticated long enough to propagate 
the disease under discussion. 

1893. July 26. American schooner Eannah McLoon, 
from Havana and Matanzas. Captain had died from yel- 
low fever and was buried on arrival. Five other cases 
en route; all convalescent when the ship arrived. Vessel 
disinfected. No other cases. 

1897. June 24. German bark Zion from Kio de 
Janeiro. Two cases while at Kio and two en route. 
Quarantined and ordered to New York without pratique. 

October 3. Norwegian steamship John Wilson, from 
Bocas del Toro, Colombia. Had previouslj^ left Mobile 
(an infected place), and had had a case of yellow fever 
before reaching the South American port, and another 
after leaving Bocas. Owing to the fact that yellow fever 
was widespread in the South that year, much excitement 
was caused at Delaware Breakwater Quarantine and 
vicinity, when news that an infected vessel had arrived 
became public. Th cargo, which consisted of bananas, 
was dumped fiYe miles at sea and the vessel ordered to 
Keedy Island for observation. No other cases developed. 

Since 1897, infected vessels have arrived at this station, 
but no interesting developments followed. 

DUCK CEEEK. 

1720. Yellow fever imported, but beyond the state- 
ment that ^^the village was almost depopulated," no other 
information can be gleaned from the historians of the 
period. 

NEW CASTLE. 

1798. Severe outbreak; no statistics. Probably in- 
fected by Wilmington. 



DELAWARE. 803 

WILMINGTON. 

1798. First case in September. Probably infected by 
refugees from Philadelphia. Deaths, 200. 

1802. Mild epidemic ''in the autumn." No statistics. 

BIBLIOGRAPHY OF YELLOW FEVER IN DELAWARE. 

Bancroft: Essay on Yellow Fever, p. 357, 

Medical Repository, 1805, vol.. 3, pp. 128; 136; 221; 336; 368. 

Monro: Remarks on the Epidemic of the Summer and Autumn of 
1798, at Wilmington, Delaware. Medical Repository, 1805, vol. 3, p. 
136. 

Tilton: Observations on the Yellow Fever as it appeared at Wilming- 
ton Delaware, in the Summer and Autumn of 1798. Medical Reposi- 
tory, 1805, vol. 3, p. 128. 

Vaughan (J.) : A Sketch of the History of the Diseases of the State 
of Delaware. Medical Repository, 1805, vol. 3, pp. 221, 336, 368. 

Vaughan: A Concise HlstOiry of the Autumnal Fever which prevailed 
in the borough of Wilmington (Del.) in the year 1902. 8vo. Wil- 
mington, 1803. 

Vaughan: An Account of Diseases at Wilmington (Del) in the sum- 
mer and autumn of 1800; of the disease originating on board of the 
U. S. Ship Ganges, etc. > Medical Repository, 1806, vol. 4, p. 238. 



DISTRICT OF COLUMBIA. 

WASHIXGTOX. 

1855. A few imported cases ''from the South." 
1878. Popuhition, 179,102. First case, August 10. 
Cases, 5; deaths, 5; all refugees from Southern cities. 
1898. One fatal case, a refugee 

BIBLIOGRAPHY OF YELLOW FEVER IN DISTRICT OF 

COLUMBIA. 

Dick: Fever at Alexandria, District of Columbia. New York 
Medical Repository, vol 7, p 130. 
Keating: History of Yellow Tcver, p. 97. 
Lancet (London), 1S55, vol. 2 p. 208. 
Medical Statistics U. S. Army, 1819-39, p. 54. 
Annual Report Supervising Surg.-Gen. U. S, 1S99, p. 391. 



FLORIDA. 

APALACHICOLA. 
182G. Sporadic cases; no statisitcs. 

BAKTOW. 
1888. Population, 2,500. A few imported cases. 

BRAIDENTOWN. 
1888. Scattered cases; imported. 

BRENT. 
1908. One fatal case, a refugee. 
CALLAHAN. 

1888. Infected by Fernandina. First case, September 
10; last case, October — . A few cases, refugees. 

1871. Infected by Havana. Mild epidemic. No 
statistics. 

DRY TORTUGAS. 

1893. One fatal case; imported. 

ELLAVILLE. 

1888. A fatal case in November; imported. 

EGMONT KEY. , 

1887. First case in July; first death, July 11. Two 
cases, resulting in death. 

ENTERPRISE. 

1888. Severe outbreak, considering the limited number 
of inhabitants. No statistics. 



806 HISTORY OF YELLOW FEVER. 

FEENANDINA. 

1877. Infected by Havana. Cases, 1,500 ; deaths, 112. 

1878. Three deaths on a bark from Matanzas, Cuba. 
1888. Infected by Jacksonville. First case, Aingust 

17, terminating fatally on the 22nd. Complete statistics 
lacking. 

FOET BAEKANCAS. 

1822. Deaths, 7. Source of infection not stated, but 
probably Havana or Pensacola. 

1853. Infected by Pensacola. Cases, 5. 

1854. Two deaths ; imported. 

1873. First case, September 26; last case, November 
12. Cases, 12 ; deaths, 3. 

1875. There are different speculations relative to the 
origin of the fever in 1875, but it is the opinion of the 
majority of writers that it was brought by the Von 
Molthe, from the West Indies, which anchored between 
Forts Barrancas and Pickens, the pilot not being able 
to bring her to the quarantine station, owing to the ad- 
verse wind and tide. It is currently believed thajt a boat 
from Barrancas with enlisted men boarded tfee vessel 
during the night to obtain liquor. It is certainly peculiar 
the men who were supposed to have gone on board, were 
the first to have taken the fever. It proved to be of a 
very virulent type, and spread with fearful rapidity. The 
commandant of the Navy Yard making a call on the citi- 
zens, they responded at once, and formed a picket guard, 
cutting off what is known as Tartar Point, and extend- 
ing from the present custom-house station to Bayou 
Grande. Not a case of yellow fever made its appearance 
in the adjacent villages or the Yard. Pensacola, having 
quarantined against Barrancas, was equally fortunate. 

1897. Cases, 4; deaths, 1. 

FOET JEFFEESON. 

1873. First case, August 24; last death, October 6. 
Cases, 25; deaths, 13. 



FLORIDA. 807 

FOET PICKENS. 
1875. Sporadic cases. No statistics. 
GAINESVILLE. 

1871. First case in August. No statistics. 

1888. Infected by Jacksonville. First case, Septem- 
ber 11, terminating fatally on the 17tli ; last case, Novem- 
ber 28. Complete statistics lacking. 

GKEEN COVE SPKINGS. 

1888. Sporadic cases. 

INDIAN KEY. 

1841. In the early part of the autumn of 1841, the 
brig Jefferson, from Mobile, Ala., where a mild outbreak 
of yellow fever was in progress, landed several cases at 
Indian Key. The disease did not spread. 

About the same time, the schooner Ostego^ "from the 
west coast of Florida," lost several of her crew at the 
Key from yellow fever, without contaminating the in- 
habitants of the village. 

INTEELOCHEN. 

1887. One case, October 7, from Tampa, terminating 
fatally on the 13th. 

JACKSONVILLE. 

1857. Severe epidemic. Probably imported from 
Havana by smugglers. No statistics. 
1877. Epidemic. No statistics. 

1888. First case in a man from Tampa, Florida, where 
"sporadic cases" had been observed, and who was taken 
ill July 29. A severe epidemic resulted. Complete stat- 
istics not given. 



808 HISTORY or YELLOW FEVER. 

KEY WEST. > 

1823. Epidemic; probably imported from Havana. 
The fever was so fatal among the United States troops 
stationed at the place, that the post was abandoned by the 
government and the soldiers removed to Pensacola. 

1824. Mild epidemic. 

1828. Epidemic 

1829. Population, 350. The epidemic of 1829 was 
probably imported from Cuba, between which Island and 
Key West much smuggling was then going on, as the 
first case was in a seaman who had been sent ashore from 
a vessel in the harbor. Deaths, 26. 

1841. Mild outbreak. No statistics. 

1853. Infected by Tampa. First case, August — ; 
first death, August — . Deaths, 2. 

1854. Cases, 240; deaths, 98. 

1862. Infected by Havana. First case, June 20 ; last 
case, October — . Deaths, 75. 

1864; 1865; 1867. Mild manifestations of the disease. 
No statistics. 

1869. Infected by Havana. No statistics. 

1875. Population 10,000. Infected by Kingston, Ja- 
maica. First case, March 19 ; first death, March 21 ; last 
death, August 11. Deaths, 38. 

1876. At Quarantine: Cases, 2; deaths, 1. I 
1878. Population, 5,000. Infected by New Orleans. 

First case, July 10 ; first death, July 11 ; last death, Octo- 
ber 19. Cases, 162; deaths, 20. 

1880. Population, 12,000. First case, Julv 16. Deaths, 
34. 

1881. First case, August 22; first death, August 27. 
Deaths, 8. 

1887. Infected by Havana. First case, May 21 ; first 
death. May 23. Cases, 283 ; deaths, 64. 

1889. Population, 25,000. First case, September 21; 
last case, November 15. Mild, sporadic manifestation. 
Cases, 7; no deaths. 

1890. One death. ! 



FLORIDA. 809 

1892. Cases, 6; no deaths. 

1893. Cases, 2; deaths, 2. 

1894. A few cases on vessels in harbor. No cases in 
town. 

1899. Cases, 1,291; deaths, 65. 

1900. A case was observed as early as January 8, in 
the person of a civilian employed at the United States 
Army Post; second case, January 16. These were un- 
doubtedly "echoes" of the epidemic of 1899, as no other 
cases occurred in 1900. 

1901. Cases, 1. 

LIVE OAK. 

1888. Sporadic cases. 

MACCLENNY. 

1888. First case, August 8. Cases, 338 ; deaths, 23. 

MANATEE. 

1888. Population, 200. Infected by Tampa. First 
case, July — ; first death, July 20. Cases 51. 

MANGO. 

1888. First case, September 2. Cases, 6; deaths, 0. 

MANY LAKES. 

1887. Cases, 2 ; deaths, 1. 

MELLENVILLE. 

1888. Cases, 2 ; deaths, 0. 

MIAMI. 
1899. Cases, 47 ; deaths, 4. 



810 HISTORY OF YELLOW FEVER. 

MICANOPY. 

1888. Cases among refugees. 

MILLLVIEW. 

1883. Population, 300. First case, September 7 ; last 
case, September 10. Cases, 70; deaths, 12. 

MILTOX. 

1853; 1855; 1869. Mild outbreaks. Xo records of 
cases and deaths. 

MOLIXA. 

1883. Infected by Pensacola. :\[ost of the cases oc- 
curred in the country adjacent to Molina, but a few being 
observed in the town. 

MULLET KEY. 

1892. Cases, 3 ; deaths, 1. 

PALATKA. 

1887. Infected by Tampa. First case, October 7 ; last 
case, October 13. Only a few cases, all imported. 
Deaths, 1. 

PALMETTO. 

1888. Population, 250. Infected by Manatee. First 
case, November 19; last death, November 23. Cases, 85; 
deaths, 11. 

PENSACOLA. 

1764. First appearance of yellow fever in Pensacola. 
No record of cases and deaths. 



FLORIDA PENSACOLA. 811 

1765. Deaths, 125. 

1810; 1811. Mild epidemic. No record of cases and 
deaths. 

1822. Infected by Havana. First case, August 12. 
Between the 13th and 20th of August, 20 deaths occurred ; 
and on the 26th, the troops abandoned the town and 
encamped on a dry elevated position in the vicinity. As 
some men were necessarily left behind to guard the public 
property, many cases occurred among them. Three med- 
ical officers, 13rs. Elliott, McMahon and Merrill, were 
attacked, the first of whom fell a victim to the disease. 
Last case, October 10. Deaths, 237. 

1824. Deaths, 2. 

1825. Yellow fever prevailed to a considerable extent 
in Pensacola during the summer of 1827. The soldiers 
suffered much. Among those attacked were Paymaster 
Wright and his whole family, his assistant, and also Dr. 
Lawson, the Army Surgeon of the post, and a sergeant. 
No record of cases and deaths. 

1828; 1829; 1830. Severe on vessels in harbor; only a 
few cases in town. 

1834. First case, August 23. Limited outbreak. 

1835. Sporadic cases. 

1839. Infected by New Orleans early in September. 
First death, September 5. Several doctors died during 
the course of the epidemic. 

1841; 1842; 1843; 1844; 1845; 1846. Mild outbreaks. 

1847. Infected by United States frigate, Mississippi^ 
from Vera Cruz. Limited outbreak. 

1848. Infected by ships from Vera Cruz. 

1853. In July, 1853, the steamer Vixen arrived at 
Pensacola Navy Yard from the West Indies, both officers 
and men suffering severely from yellow fever. They were 
at once sent to the Naval Hospital, situated about one- 
half mile west of the yard. The vessel was put out of 
commission, hauled along side one of the yard wharves, 
and employes were sent aboard to tallow machinery and 
clean bilges. These men were, with scarcely an exception, 
taken sick with virulent yellow fever, and the spreaa 



812 HISTORY OF YELLOW FEVER. 

of the epidemic could be distinctly traced, step by step, 
to this focus. The scourge raged with fearful yiolence 
from the latter part of July to about the 10th of October, 
carrying off about 260 yictims out of a population of 
only 1,200. 

1851. Infected by ship Yixen^ from Tampico, Mexico. 
1858. Sporadic cases. 

1863. Infected by United States ordnance supply yes- 
sel Nightingale. At the time the Ciyil War was in pro- 
gress and there were some 1,500 people in the town, due 
to a heayy influx of refugees, besides a floating population 
of about 2,000 more. It is impossible to estimate the 
number of deaths, but the hayoc caused by the pestilence 
was fearful, it being a common occurrence to see four 
or fiye coffins carried in a grayeyard in an oxen-team, 
the only ayailable conyeyance at the time. Most of the 
men belonging to the mortar fleet were camped on the 
island, and it is said that more than 200 people were 
buried there. The feyer was of a yirulent kind, which 
did not spare the acclimated portion of the community. 
Strange to relate at that time there were about 3,000 
troops stationed at and about Barrancas, and not a case 
of feyer occurred at that point, owing to a strict quaran- 
tine picket being kept by cayalry extending from the 
hospital to the bayou, men being close enough to hail one 
another. 

1867. Infected by Jamaica. The United States gun- 
boats Tacony and Yucca were at the Nayy Yard at the 
time. The officers and men had free intercourse with 
Pensacola, little suspecting the danger to which they were 
exposing themselyes, until two men belonging to the 
Tacony, who had been on liberty and in Pensacola, were 
taken sick with yellow feyer. The infection spread rap- 
idly. The total number of cases could not be ascertained, 
but the deaths were 227. 

1873. Infected by Hayana. First case, August 5 ; last 
case, October 15. Cases, 600 ; deaths, 62. 

1874. Population, 3,347. Number who fled, 1,947. 



FLORIDA. 813 

Infected by Havana. First case, August IT; last case, 
November 9. Deaths, 354. 

1878. Population, 5,000. American brig A. K. Bar, 
from Cuban ports, arrived August 17 Avitli the mate dead 
and crew sick with yellow fever. The cases were se(i wes- 
tered, and Pensacola escaped an invasion. 

1882. Infected by bark Balcta, from Matanza. IMrst 
case, 'August 8 ; first death, August 26 ; last case, Novem- 
ber 26 ; last death, November 29^ Cases, 2,351 ; deaths, 198. 

1883. The Pensacola Navy Yard was infected by 
Havana, the first case erupting May 27 ; first death, June 
2. From this focus, the fever was carried to Pensacola. 
The first case being re]3orted August 5, and the first 
death en the 11th. "^Cases, 261; deaths, 34. 

1884. , Sporadic cases. 

1891. Cases, 2; deaths, 1. 

1893. Cases, 2. 

1897. One fatal case at Quarantine. 

1905. Cases, 564; deaths, 81. 

PLANT CITY. 

1887. Population, 300. Infected by Tampa. First 
case, October — ; first death, November 14; last case, 
August 18. 

1888. Population, 300. Number who fled, 100. First 
case, June — ; first death, June 22; last case, August 18. 
Deaths, 21. 

PEOGKESO. 

1887. First case, September 30. Cases, 6; deaths, 1. 
SANFOED. 

1887. Infected by Tampa. First case, October 8. 
Cases, 150; deaths, 8. 

1888. Among refugees. No record of cases and deaths. 

1889. Population, 3,000. An imported case died April 
23. 



814 HISTORY OF YELLOW FEVER. 

ST. AUGUSTINE. 

1807. First invasion by yellow fever. Xo statistics. 
1819. Mild epidemic. Xo record of cases and deaths. 

1821. Infected by Havana. First case in August. 
Deaths, 140. 

1838. Mild outbreak. 'No record of case and deaths. 

1839. Infected by Charleston. First case, August 15. 
No statistics. 

1841. Infected by Havana. Deaths, 26. 
1877. Infected by Fernandina. First case, Xovember 
9. Cases, 250 ; deaths, 50. 

ST. JOSEPH. 

1841. Sporadic cases. Xo statistics. 

ST. MARKS. 

1822. First cases in August. Cases, 68; deaths, 5. 

SUWANEE. 

1835. A few cases. Xo record. 

1836. First case, August — ; last case, November, 10. 

TALLAHASSEE. 

1841. Infected by refugees from "towns along the 
coast." No record of cases and deaths. 

1867. A fatal case in September. Source of infection 
not stated. 

TAMPA. 

1839. Sporadic cases. No record. 

1871. Infected by Havana. No statistics. 

1887. October 7.' Cases, 400 ; deaths, 75. 

1888. Last case, December 3; deaths, 10. 

1899. A fatal case; imported. 

1900. Refugees. No records of cases and deaths. 
1905. One case; imported. 



FLORIDA. 815 

TOKTUGAS. 

1862. Deaths, 4. 

1867. First case, July 4. Deaths, 38. 

1898. Cases, 5; deaths, 0. 

1897. At quarantine. No record of cases and deaths. 

WAEKINGTON. 

1874. Population, 1,000. Deaths, 13. 

1883. Infected by Pensacola. Sporadic cases. 

WOOLSEY. 

1874. Population, 1,000. Deaths, 14. 

1883. Infected by Pensacola. Sporadic cases. 

BIBLIOGRAPHY OF YELLOW FEVER IN FLORIDA. 
GENERAL.. 

Epidemic of Yellow Fever in Florida. Rep. Superv. Surg. -Gen. Mar. 
Hosp. Wash, 1888, p. 24, 4pl. Imap. 

Gibier (P) : Investigaciones sobre la Fiebre Amarilla. (Segunda 
Serie., Epidemia de Florida, 1888.) Cron. Med. Quir. de la Habana, 
vol.. 15, p. 62. 

Holt (Joseph.) : A Letter upon the Causes of the Introduction of 
Yellow Fever in Florida, and Advice as to Disinfection and Sanitation. 
8°. (New Orleans, 1888.) 

BARRANCAS. 

Herron (J. S.) : Yellow fever at Barrancas, near Pensacola, Fla., 
in 1875. Rep. Superv. Surg. Mar. Hops., 1874-5, Wash., 1876, 139-143. 

FERDINANDA. 

Horsey (C. W.) : Report of the epidemic of yellow fever at Fernan- 
dina, Fla., in August, September and October, 1877, Proc, Fla., M. 
Assn., 1878, p. 51. 

Maxwell (G. T.) : Yellow Fever Epidemic of 1887 and 1888 in Florida; 
Testimony of Dr. George Troup Maxwell; Correspondence with Prof. 
Joseph Jones, Virginia Med. Monthly, Richmond, 1889-90, vol. 16, 
p. 266. 



816 HISTORY OF YELLOW FEVER. 

Murray (R. D.): Yellow fever epidemic at Fernandina, Rep. Superv. 
Surg. Mar. Hosp., Washington, 1878-9, pp. 191-199. 

Ross (J. W.) : The yellow fever at Fernandina. Rep. Superv. Surg.- 
Gen. Mar. Hosp., Wash, 1888-9, p. 76. 

Starbuck: Notes on the Epidemic of Yellow Fever at Fernandlaa, 
Fla. Rep. Superv. Surg.-Geu. Mar.. Hospital, Wash, 1888-9, p. 83. 

GAINESVILLE. 

Martin (W.) : The Yellow Fever at Gainesville, Fla. Rep. Superv. 
Surg.-Gen. Mar. Hosp. Wash, 1889, p. 85. 
McKinstry (J.): Yellow Fever as Observed in Gainesville Epidemic, 

1888. Proc. Fla. Med. Assn., Jacksonville, 1889, p. 43. 

Voyle (J) : The Epidemic of Yellow Fever at Gainesville, Fla., and 
Deductions Therefrom. Proc. Quarant. Confer., Montgomery, Ala., 

1889, p. 71. 

JACKSONVILLE. 

Daniel (R. P.): Report on Yellow Fever in Jacksonville, Fla., in 
1877. Proc. Fla. M. Assn., 1878, p. 23. 

Daniel (R, P.): Epidemic in Jacksonville, Fla., 1888. Proc. Fla. 
Med. Assn., Jacksonville, 1888, p. 57. 

Jones (Joseph) : Scientific inquiries with reference to the Yellow 
Fever Epidemic in 1888, in Jacksonville, Fla., Addresses to several 
Physicians engaged in its Treatment, with replies thereto. Atlanta 
Med. and Surg. Jl., 1889-90, n. s. vol. 6, p. 387. 

Mitchell (S ) Remarks upon the Yellow Fever Epidemic of 1888, at 
Jacksonville, Fla., N. Y. Med. JL, 1889, vol. 49, p. 305. 

Stout (H. R.) : The Epidemic of Yellow Fever at Jacksonville, Fla., 
in 1888, N. Am. Jl., Homoeop,, N. Y. 1890, 3 s. vol. 5, p. 428. 

KEY WEST. 

Annual Report Sup. Surg.-Gen. U. S. Army, 1875, p. 120. '(Daily 
mortality in Key West in 1875). 

Bemiss (S. M.) : Yellow Fever at Key West, Fla. Rep. Nat. Bd. 
Health, 1881, Wash., 1882, vol. 3, p. 281. 

Dupre (C. C.) : On the Yellow Fever of Key West, East Florida. 
American Journal of Medical Sciences, N. S. vol. 2, p. 380. 

Guiteras (J.): Some observations on the Natural History of 
Epidemics of Yellow Fever, based on a Study on the Mortalitj^ 
Statistics of the City of Key West; also a plea in favor of a continued 
investigation of this disease by the Government of the United States. 
Rep. Superv. Surg.-Gen. Mar. Hosp.., Wash., 1888, p. 75. 



FLORIDA. 



817 



Maxwell (G. T.) : Letter describing the yellow fever as it appeared 
at Newport, Fla., in 1853, and Key West, Fla., in 1857.. Charleston M. 
J. & Rev., 1874, vol. 2, pp. 145-150. 

Moreno (M. R.): Our Board of Health and Yellow Fever. Key 
West, Fla., June 9, 1887. The Evening Call, Key West, Fla., June 10, 
1887. 

Perry (R. J.) : Yellow Fever at Key West, Fla., 1878. Hyg. & M. Rep. 
U. S. Navy, Wash., 1879, vol. 4, p. 729. 

Sampson: Med. Statistics U. S. Army, 1839-1^55, p. 323. 

Ticknor: An Account of the Yellow Fe\er which prevailed at 
Thompson's Island in the year 1824. North J>imerican Med and Surg. 
Journal, vol. 3, p.. 313; vol. 4, p. 1. 

MACCLENNY. 

Posey (J.. L.): Yellow Fever at Macclenny, Fla. Rep. Superv. Surg.- 
Gen. Mar. Hosp., Wash., 1889, p. 96. 

MANATEE. 

Wall (J. P.) : The ycllcw fever in Tampa, Plant City, Manatee and 
Palmetto. Rep. Superv. Surg-Gen. Mar. Hosp., Wash., 1889, p. 60. 

MILLVIEW. 

Anderson (W. E.): Yellow fever epidemic at Millview, Fla., 1SS3. 
Rep. Bd. Health Ala., 1883-4, Montgomery, 1885, p.. 113. Also: Tr. M 
Assn. Ala., Montgomery, 1884, vol. 36, p. 236. 

PENSACOLA. 

Blount: Yellow Fever on Ship Emma Payzaht. Med. Record, N. Y., 
1881, vol. 20, p,. 112. 

Boston Medical & Surg. Jl., 1834, vol. 11, p. 153. 

Bouvier (E.) : Yellow Fever in Pensacola. Proc. Fla. Med. Assn., 
1886, p. 36. 

Bouvier (E.) : Sanitary condition of the city of Pensacola and 
vicinity, 1883; report of some sporadic cases of yellow fever, of 
hygienic measures adopted on quarantine and sanitary cordons, pend- 
ing the period from 1st of April to the 15th of November, 1883, in the 
city of Pensacola, Fla., and in it;j vicinity. Rep. Superv. Surg.-Gen. 
Mar Hosp., W^ash., 1883-4, p. 251. 

Cochran: (Epidemic of 1873). Trans. Ala. State Med. Assn., 1874, 
pp. 113, 126. 

Cochran (J) : Report on yellow fever in Pensacola in 1883. Rep. 
Bd. Health Ala., 1883-4, Montgomery, 1885, p. 96. Also: Tr. M. Assn. 



818 HISTORY OF YELLOW FEVER. 

Ala. Montgomery, 1SS4, vol. 36, p. 206, 233. 

Dowell: Yellow Fever and Malarial Diseases (Phila., 1S76), p. 41. 

Gibbs (B. F,) : Account of the epidemic .?f yellow fever which 
visited Pensacola navy-yard in the summer anJl autumn of 1863. Am. 
J. M. Sc, Phila., 1S66, n. s., vol. 51, p. 340. 

Guiteras (D. M.) : Notes on Vn.e yellow fever at Pensacola in 1883. 
Proc. Xaval Med. Soc, Wash., 18824, vol. 1, p. i ■:.?.. 

Hargis (R. B. S.) : Yellow fever epidemic at Pensacola. X. O. M. & 
Surg. Jl., 1873-4, n. s., vol. 1, p. 781. 

Hargis (R. B, S.): The Pensacola yellow fever empidemic of 1882. 
Am. Pub. Health Assn., Rep. 1883, Concord, X. H., 1884, vol. 9, p. 306. 

Herron (J. S.) : Yellow fever at Pensacola in 1874. Rep. Superv. 
Surg, Mar. Hosp., Wash., 1873-4, p. :95. 

Martin (W.) : Conclusions as to the outbreak of yellow fever Dt 
Pensacola in 1882. Proc. Xaval Med. Soc, Wash., 1882-4, vol. 1, p. 168. 

Porter (J. G.) : Yellow fever in Tampa and Pensacola, Florida, 1905 
Rep. Surg.-Gen. U. S. P. H. & M. H. Service for 1906 (Wash,, 1907), 
p. 173. 

Report on Yellow Fever and Quarantine; visit to Pensacola. Tr. M. 
Assn. Ala., Montgomery, 1883, p. 144. 

Report of the outbreak of the yellow fever epidemic at the nav.d 
station, Pensacola, Florida, 1'n67. Med. & Surg. Reporter, Phila , 1868. 
vol.17, p. 227. 

Sternberg (G. M.) : Yellow fever in Pensaccl:^, Fla., in 1873, 187 i, 
and 1875. Am. Pub. Health Assn. Rep. 1875, >J. Y., 1876, vol. 2, p. 46^. 

Townsend (P. S.): Account of the Introduction of the Yellow Feve-' 
into Pensacola and Xew Orleans in the year 1822. Xew York Medicr.l 
and Physical Journal, vol. 2, p. 315. 

Tryon (.J. R ): Epidemic of yellow fever at the navy yard, Pensaco a, 
Fla., during the summer and fall of 1S74. San. & M. Rep. U. S. Xavy 
1873-4, Wash., 1875, p. 451. 

The Yellow fever at Pensacola (1882). Med Xews, Phila., 1883, vol 
13, p. 233. 

Yellow Fever at Pensacola. Proc. Fla. Med. Assn., Jacksonville, 
1886, p. 36. 

Wilson (J) et al.: Report of a naval medical board to investigate the 
circumstances connected with the visitation of yellow fever at navy 
yard, Pensacola. Hyg. & M. Rep. U. S. Xavy, Wash,, 1S79, vol. 4, p. 699. 

PALMETTO. 
Wall. J. P.: (Loc. cit.) 

PLAXT CITY. 

United States Congress. . Senate. A bill for the relief of Wm, P. 
Head, of Plant City, Fla. (Compensation for loss destroyed by fi.e 



FLORIDA. 819 

while in possession .of the Mar. Hosp. Board, whilst heing fumigalo'i 
in the Summer of 1888, for the purpose of eradicating the germs of 
Yellow Fever.) 51st Cong., 1st Sess. S. 1746. Jan. 6, 1890, Tntrrd. 
by Mr. Pasco. Roj\ 8vo.. (Wash., 1890.) 
Wall. J. P.: (Loc. cit.) 

SAINT AUGUc^TINE. 

Strobel, p. 131. 

SAINT JOSEPH. 

Boston Med. & Surg. JL, IS—, vol. L'5, p. 17. 

TAMPA. 

Porter, J. G, : (Loc. cit.) 

Raymond, H. I.: Yellow Fever at Camp Tampa Heigh!>:. Medi?'U 
News (1898), vol. 72, p. 683. 
Wall. J. P.: (Loc. cit.) 



GEORGIA. 

ATLANTA. 

187G. A few eases, refugees from Sayannah. 
1897. Eefugees. Cases, 3; deaths, 0. 
1905. One fata] case, a refugee. 

AUGUSTA. 

1825. At arsenal. Gases, 31 ; deaths, 7. No diffusion 
of the disease. 

1839. During the summer of 1839, most of the cities 
of the Southern States suffered severely from yelloAV fever. 
Although the city of Augusta experienced its worst rav- 
ages, the garrison of this post, with the excei)tion of one 
case, was exempt from the fatal epidemic. This man 
passed a night in the city, in a state of intoxication. 

In regard to the origin of this epidemic which began 
in July, much diversity of opinion, as has been found to 
obtain at all periods existed. A committee consisting of 
physicians of August, by whom the question of its origin 
and cause was carefully investigated, reported that the 
disease was of domestic origin, a tenet which cannot be 
countenanced at the present day, but which was seriously 
accepted then. The fons et origo mall was traced to a 
point called ''trash wharf," a slide or inclined plane, 
erected in 1834, for the purpose of throwing the filth of 
the city, including' dead animals, into the river. This 
mass of animal and vegetable matter having accumulated 
to the upwards of 200,000 cubic feet, it was resolved by 
the authorities of the city to have it removed. Accord- 
ingly, during the months of May and June, ''its interior 
was exposed to the action of the sun." Having penetrated 
the exterior crust, the heat evolved was so great that the 
workmen, although wearing thick shoes, were compelled 
to desist from their work, "for two hours at a time, so as 
to suffer it to cool." 



GEORGIA. 821 

The excavation of this trash heap was given by the 
Commission as the cause of the epidemic, but we are more 
prone to accuse the proverbial ^^ship from the West 
Indies.'' The number of cases and deaths is not stated. 

1854, A few imported cases. 

1876. Infected by refugees from Savannah. Outbreak 
not general, but confined to persons residing in the neigh- 
borhood of the railroad freight yards. Cases, 20 ; deaths, 4. 

BLACKSHEAK. 

1887. One case; imported 

BAINBRIDGE. 
1873. Sporadic cases. 

BRUNSWICK. 

1876. Infected by Havana. First case. August 20; 
first death, August 21. Deaths, 112. 

1881. A few cases at Quarantine. 

1890. There is no ^'offlciaP' record of the prevalence 
of yellow fever in Brunswick in 1890, but during the ex- 
amination of the mortuary records of the town by officials 
of the United States Marine Hospital Service in con- 
nection with the yellow fever epidemic there in 1893, it 
was demonstrated, by the peculiar /'jumps" in the mor- 
tality, that the disease had prevailed in Brunswick in 
1890, and had been kept concealed. Not only did the 
mortuary records show this, though the cases were not 
diagnosed as yelloNV fever, but evidence of creditable cit- 
izens was obtained to this effect; and reliable testimony, 
that one of the physicians of Brunswick had made the 
statement in the fall of 1890, that yellow fever was pre- 
valent — almost epidemic — and ''if the Lord did not send 
a frost soon, it would be impossible for them longer to 
conceal it." It is known now that yellow fever had ex- 
isted in 1893, a month prior to its being declared epidemic. 

1893. The America.i barkentine Anita Bericind, from 



822 HISTORY OF YELLOW FEVER. 

Havana, arrived at the Brunswick quarantine — good san- 
itary history— June 15, 1893. Cleared June 19, 1893, 
presumably three days after disinfection. The master, 
who is said to have been feeling badly before leaving, 
was in Brunswick. The vessel reached Conquest's wharf 
on the Satilla (only a wharf with no people living there) 
on the 20th, on the evening of which day the master took 
to his bed. On June 21 he was moved to Conquest Camp, 
a cross-tie camp, 8 miles distant from Brunswick, where 
he died on June 25. Diagnosis during sickness and an 
autopsy by Dr. Dunwoody, yellow fever. 

Two colored women nursed the patient and several 
men were especially exposed towards the last of his life 
and after death; Drs. Atkinson and McKinnon attended 
him. With the exception of burning the mattress and 
bedding, no disinfection worth anything was practiced, 
and there was no isolation save what the fears of the 
people compelled; the two nurses sleeping in the house 
and circulating freely among the others. There were 73 
persons in the camp, living in small houses scattered 
through the brush. 

Suspicious cases subsequently erupted in the vicinity, 
and there undoubtedly were cases in Brunswick, but it 
'was only on September 9, when Surgeon Brenham, of the 
United States Marine Hospital Service, -was taken ill and 
his case diagnosed yellow fever, that the disease was 
officially declared present in the town. The first death 
among the inhabitants of Brunswick reported as yellow 
fever took place September 13. Dr. Brenham died on 
the 20th. Te fever was not of a virulent character, for 
out of 1,001 reported cases, only 53 died — 40 whites, 12 
negroes and 1 Mongolian. A notable feature of this epi- 
demic was the unusual naortality among the blacks. 

1894; At quarantine, , two deaths. 

1897. A few cases at quarantine. 

1899. Cases at quarantine. 



GEORGIA. 823 

CONQUEST CAMP. 

{See Brunsiviclc^lS9S), 

DAKIEN. 

1876. Infected by Doboy. First case, September 26; 
last death, November 7. Cases, 8; deaths, 2. 

1879. On bark Caspian, from Havana. First case, 
August 24 ; last case, August 24. Cases, 4 ; no details. 

DALTON. 

1878. Infected by Chattanooga, Tenn. First case, Oc- 
tober 2, terminating in death on the 4th. Cases, 3; 
deaths, 3. 

BOBOY ISLAND. 

1876. Infected by bark Valentine^ from Havana. No 
record of cases and deaths. 

FOKT OGLETHORPE. 

1828. Deaths, 10. 

ISLE OF HOPE. 

1876. The Isle of Hope is ten miles southeast of Savan- 
nah, with which city it is in constant railroad communi- 
cation. It has always been considered a place of refuge 
during seasons of epidemic influence; in 1876 at least 
three thousand individuals were added to its population. 
The first case of yellow fever which occurred in this 
locality in 1876 was in the person of a man named De 
Gauge, a refugee from Savannah. This man slept on the 
island, but spent each day in the city. He died about thd 
22nd of September. The second case was in the person 
of a man named Grover, also a refugee from Savannah, 
who only slept on the island. He died on the 23rd of 



824 HISTORY OF YELLOW FEVER. 

September. From these eases the disease spread, and 
many fatal cases occurred. 

Opposite the Isle of Hope, and at but a comparatively 
short distance from the houses in which the epidemic in- 
fluence was most strongiy exihibited, is the celebrated 
Bethesda School, at one time so dear to the heart of 
John Wesley. At this point a considerable number of 
persons were congregated, but no case of the disease 
occurred. 

JEKYL ISLAND. 

1893. Imported cases. 

JESUP. 
1893. Sporadic cases; imported. 

]\[ACON. 

1876. Early in October two cases of yellow fever oc- 
curred in the persons of employees of a Macon cotton 
^nnery. At the residences of these persons were sev- 
eral refugees from Savannah. Both of these cases died 
with black vomit. After these deaths occurred, the 
refugees removed to other portions of the city, where they 
were subsequently taken with the disease, and in one in- 
stance a fatal case again occurred from their presence. 
During the prevalence of this slight outbreak, the greatest 
number of cases occurred on the two blocks between 
Fourth and Fifth Streets, and Pine and Oglethorpe 
Streets, immediately in front of the Southwestern Eail- 
road depot, at which all freight from Savannah was re- 
ceived and delivered. A few cases occurred in the vicinity 
of the Macon and Brunswick Railroad depots, and other 
sporadic cases in the vicinity of the railroad yards. 

OLIVER STATION. 

1876. During the epidemic in Savannah, a case oc- 
curred at Oliver Station, on the Georgia Central Rail- 



GEORGIA. 825 

road. For the accommodation of the Central Eailrcad 
employees and the citizens of Savannah during the epi- 
demic, a daily train was run to this station, which is 
some forty odd miles from the city. The train remained 
at Oliver over night and returned to the city in the 
morning. 

On the night of September 10, a man named Lufburrow 
slept on board this train, and on the 16tli was suddenly 
taken with yellow fever, of which he died on the 21st. 
This man had not been to the city, and the only contact 
which he had with infection was on the night he slept 
in the cars. 

Two cases of the disease occurred f-mong some United 
States troops who were encamped at this point, having 
evacuated their barracks in Savannah on account of the 
epidemic, but on other cases occurred in the locality. 

SAVANNAH. 

1801; 1807; 1808. Mild epidemics. No records. 

1817. Cases were observed earlier than usual in 1817, 
and by July the disease was epidemic. No record of 
cases and deaths. 

1818. Mild outbreaks. 

1819. The epidemic of 1819 made its appearance in the 
latter part of June, and went on increasing in extent and 
destructiveness, until the frost came and ended it. 

1820. Population, 5,000. The disease made its appear- 
ance in May. A death occurred on the 7th, another on 
the 10th, and another on the 30th of that month. In June, 
the mortality was augmented to a death on every second 
day, and the whole sum, at the end of the month, 
amounted to 14. In July, the number of deaths ran up 
to 39, being an advance to more than double the devasta- 
tion of June. In August, it amounted to 111; in Sep- 
tember, to 241; in October, to 268; in November, to 50, 
and in December, to 3. The degree of mortality, on the 
surface of this statement, appears to have undergone a 
gradual reduction after the month of September. But 



8i6 HISTORY OF YLELOW FEVER. 

when it is considered, that, in the course of this period, 
the population had been greatly diminished by absence 
and death, it becomes evident, that, so far from having 
sustained any diminuition, it was really increased 
throughout the month of October. The whole aggregate 
of deaths resulting from the epidemic, from its commence- 
ment in May, to its conclusion in December, was at 666. 

When the epidemic first appeared in May, the popula- 
tion of Savannah was computed at 5,000 whites. In 
June, and beginning of July, it was probably reduced, 
from emigration, to 2,500 ; and, on the 14th of September, 
when the Mayor's proclamation was published, the num- 
ber was still further reduced, and could not have exceeded 
1,500. The medial population, therefore, of white inhab- 
itants, may be fairly estimated at 3,000, for the whole 
season; which would constitute a sum of mortality 
amounting to one in five. 

1821 ; 1827 ; 1831 ; 1839 ; 1850. Epidemics of more or 
less intensity. No authentic records. 

1852. Deaths, 19. 

1853. Sporadic cases. 

1854. The first case of yellow fever to precede the epi- 
demic of 1854, occurred on August 5, at the corner of 
Lincoln and Broughton Streets. Eegarded merely as a 
sporadic case, it was not reported as yellow fever, and na 
precautions were taken. Between that date and the mid- 
dle of the month, a few more cases occurred, but the 
health authorities remained inactive, scoffing the idea of 
the disease becoming epidemic. Soon after that date, 
cases manifested themselves in almost every quarter of 
the town and the pestilence soon swept with fearful deso- 
lation over the entire city. Following is a record of the 
deaths : 

August 132 

September 381 

• October 67 

Total 580 



GEORGIA. 827 

Notwithstanding the large negro population of Savan- 
nah at the time, only about 15 of that race died from 
yellow fever during the epidemic. 

The disease exhibited its greatest violence from the 
20th of August to the 20th of September, having com- 
menced as an epidemic in the northeastern part of the 
city; it advanced directly to the southwest, spreading 
north and south until its influence was felt in every part 
of the city. 

The infection is said to have been brought from Havana 
by the brig Charlotte Hague. 

1858. Sporadic cases. 

1876. The year 1876 witnessed the most mortal epi- 
demic of yellow fever which has ever visited Savannah. 
Between August 21, the date of the first recorded death, 
to December 1, when the last death took place, the pestil- 
ence carried off 1,066 persons, of which 809 were white 
and 257 black. 

The infection is said to have been brought by a vessel 
from Havana, either the brig Ynez (which arrived on 
July 16), the bark Maria, (July 17), or the brig Pepe 
(August 2). But which of these was the active agent of 
transmission, has never been definitely settled. 

The first recorded death from yellow fever occurred on 
August 21, on Wright Street, a short cul de sac, about 
Mtj yards long, the culmination of Bryan Street, in the 
northeastern part of the city. The second occurred in 
the same street and same locality, August 22. The third 
and fourth, August 26, same locality.. The fifth y.Angnst 
26, on East Broad Street, two doors north of Broiighton ; 
the siwth, August 27, on Reynolds Street, next to Gas 
House; the seventh, August 27, on Broughton Street, 
three doors west of Reynolds; the eighth, August 27, on 
East Boundary Street, north end; the ninth, August 27, 
on Randolph and President Streets. 

On August 28, five deaths were recorded, one on Stone 
Street, one on State Street, between Whitaker and Bar- 
nard, and the remaining three in the northeastern part of 
the city. 



8^8 HISTORY OF YELLOW FEVER. 

On August 28, the other two not specified. 

After this the disease spread rapidly, and was not con- 
fined to any locality. The highest number of deaths in 
the city from yellow fever in any one day was thirty- three, 
on the 20th of September. These occurred in the fifth 
week of the epidemic, embracing the period between the 
18th and 24th of September. 

SOriTH ATLANTIC QUARANTINE STATION. 

1887. Infected by Para. First case, May 22. 
1889. One case, April 12; recovered. 

1891. No record of cases and deaths. 

1894. No record of cases and deaths. 

1895. Cases, 1 ; deaths, 1. 

ST. MARY'S. 

1808. First case, September 5; last cas(^, October — . 
Deaths, 84. 

UPTONVILLE. 

1888. First case, October 24. Cases, 2 ; no deaths. 

BIBLIOGRAPHY OF YELLOW FEVER IN GEORGIA. 
GENERAL. 

Felder (W. L.): Observations on the Yellow Fever Epidemic of 
1854, in Augusta, Georgia. Southern M. & S. J., Augusta, 1855, vol. 
11, p. 598. 

Holt (W. F.) : Report of the State Board of Health of the late 
epidemic of yellow fever in the State of Georgia. (With appendix > 
Report Board of Health Georgia, 1876. Atlanta, 1877, vol. 2, pp. 1, etc. 

Kollock (P. M.) : Notes on the epidemic fever in 1854., Southorn M. 
& S. J., Augusta, 1855, n. s., vol. 11, p. 453. 

Logan (J. P.) : Observation in regard to the yellow fever epidemic 
of 1876 upon the coast of Georgia. Richmond & Louisville M. J, 
Louisville, 1877, vol. 23, p. 223. 

McClellan (E.) A study of the yellow fever epidemic of 1876, as it 



GEORGIA. 829 

affected the State of Georgia. Trans. Am. Pub. Health Assn., 1877->;, 
vol. 4, p.. 249. 

Seagrove (J.) : Origin of yellow fever in the contaminated air of a 
coasting vessel, and of the town of St. Mary's, in Georgia; with dn 
enumeration of its symptoms and mortality, and the beneficial effe'^ts 
of volatile alkali as a remedy, during the autumn of 1808. Med 
Reposii., N. Y., 1810, vol. 13, p. 135. Also: Am. M. & Phila. Reg., N. 
Y., 1814, vol. 3, p. 417. 

White (J. E.): Typography of Waynesborough (Georgia) and its 
vicinity, with the State of the thermometer and weather for part of 
the year 1802; to which is added some account of the disease which 
prevailed, and a few observations on yellow fever, and the princip;'.! 
remedies of fever. Med. Repository, N. Y., Second Hexade, vol. 3, 
pp. 36; 140; 241. 

ATLANTA, 

McLellan: Trans. Am. Pub. Health Assn., 1877-8, vol. 4, p. 282. 

Sawtelle (H. W.) : Report of Measures taken at Atlanta, Ga., in con- 
nection with the Yellow Fever Epidemic of 1897, under the direction 
of the Surgeon-General. Rep. Superv. Surg.-Gen. Mar. Hospi 1896-7, 
Wash., 1899, p. 665. 

Summerall (W. B.) : The case cf yellow fever recently occurring in 
Atlanta, Ga., history, clinical notes, and observations. Atlanta J. Rec 
Med., 1905-6, vol. 7, p. 505. 

U. S. Public Health Reports, 1897, p. 1419. 

Ibid., 1905, p. 2754. 

AUGUSTA.. 

Austin: Trans. Am. Pub. Health Assn., 1877-8, vol. 4, p. 234. 

Campbell: Ibid., 1879, vol. 5, p. 132. 

McLellan: Ibid., 1877-8, vol. 4, p,. 281. 

Boston Medical <& Surgical Jl., 1839, p. 36. 

Medical Statistics U. S. Army, 1819-1839, pp. 37, 349. 

Nashville Jl. Med. & Surgery, 1854, p. 345. 

Report of the Origin and Cause of the late Epidemic (Yellow Fever) 
in Augusta. Submitted to a meeting of the physicians of Augusta on 
the 10th of December, 1839. Reprinted by order of Council, November, 
1877. 8vo. Augusta, 1877. 

Robinson (F. M.) : A Report on the Origin and Cause of the late 
Epidemic in Augusta, 1839. Augusta, 1839. 

Smelt: An Account of the Epidemic Disease which prevailed at 
Augusta (Georgia) and its Neighborhood in 1804. Medical Repository, 
vol. 9, p. 125. 



830 HISTORY OF YELLOW FEVER. 

BRUNSWICK. 

Booth (A.. R.) : Tables Showing the results of Observations with 
Regard to Remittent and Yellow Fevers, taken During the Yellow 
Fever of 1893, in Brunswick, Ga. Rep. Superv. Surg.-Gen. Mar. Hosp., 
1894. Wash., 1895, p. 323. 

Faget (C.) : Some Observations on Yellow Fever in Brunswick, Ga., 
in 1893.. Rep. Superv. Surg.-Gen. Mar. Hosp., 1894. Wash., 1895, p. 
328. 

Le Hardy (J. C.) : The Yellow Fever Epidemic of Brunswick and 
its management by the Marine Hospital Service. Virginia Medical 
Monthlj^ Richmond, 1894-5, vol. 21, p. 594; 688; 835; 961; 1103; 1200. 

McLellan: Loc. cit., p. 275. 

Smith: Ann. Rep. Surg.-Gen. U. S., 1876., pp. 77, 185. 

Elliott: Nat. Board of Health Bulletin, 1881-2, vol. 3, pp. 92, 127. 

Ann. Rep. S.-G., U. S., 1894, p. 298. 

U. S. P. H. Reports, 1894, vol. 9, pp. 668, 728. 

Ibid., 1897, p. 775. 

BAINBRIDGE. 

Washington Republican, Oct. 25, 1871, p.. 1. 

BLACKSHEAR. 

U. S. Pub. Health Rep., 1888, p. 192. 

DARIEN. 

McLellan, loc. cit., p. 279. 

Harris: Nat. Bd. Health Bulletin, vol, 1, p. 104. 

D ALT ON. 

Keating: History of Yellow Fever, p. 93. 
Trans. Am. P. H. A., vol. 4, p. 251. 

FORT OGLETHORPE. 

Med. Stats. U. S. Army, 1819-1839, p. 66. 

ISLE OF HOPE. 

McLellan, loc. cit., p.. 280. ' '< 

MACON. 
McLellan, loc. cit,, p. 281. ; j 



GEORGIA. 831 

OLIVER STATION. 

McLellan, loc. cit,, p. 281. 

SAINT MARY'S. 

Seagrove (James) : An Account of the Origin and Nature of the 
Yellow Fever, as it prevailed in the Town of St. Mary's, Georgia, in 
the Autumn of 1808. Medical Repository, vol. 13, p. 135; Medical 
Register, vol. 3, p. 417. 

SAVANNAH. 

Arnold (D.), of Savannah: Two Cases of Black Vomit, with Observa- 
tions. American Journal of the Medical Sciences, N. S., vol. 3, p. 316. 

Austin: Trans. Am. P. H. A., 1877-8, vol. 4, p. 234. 

Berenger-Feraud, pp. 88, 89, 108, 134. 

Byrd (H. L.) : A few facts relating to the late epidemic of yellow 
fever in Savannah. Oglethorpe M. i& S, J., Savannah, 1858-9, vol. 1, 
pp. 286-301. 

Chaille: Virginia Med. JL, 1858, p. 491. 

Daniell (W. C.) : Observations upon the Autumnal Fevers of Savan- 
nah. 8vo. Savannah, 1826,. 

De la Motta (J.) : An oration on the causes of the mortality among 
strongers, during the late summer and fall. 8°. Savannah (1820). 

Falligant (L. A.): A monograph of the yellow fever of 1876, in 
Savannah, Ga., N. Am. J. Homoeop. N. Y., 1878, vol. 26, pp. 289, 458. 

Falligant (L. A.) : Report on . the epidemic of yellow fever in 
Savannah, Georgia, during the months of September, October and 
November, 1876. N. Am. Homoeop. J., N. Y,, 1878, vol. 26, pp. 289, 458. 

Hume (W.) : On the introduction of yellow fever into Savannah in 
the year 1854, in reply to a letter from R. C. Mackall. Charleston M. 
J. & Rev., 1856, vol. 11, p. 1. 

Le Hardy (J. C.) : Yellow fever; its history, causes, nature, path- 
ology and treatment; considering exclusively the epidemic of 1876 in 
Savannah. Tr. Georgia M. Assn., Atlanta, 1878, vol. 29, p. 64. 

Mackall (R.' C.) : Introduction of Yellow Fever into Savannah in the 
year 1854.. Charleston Medical Journal, 1885, vol. 10, p. 150. 

Russell (H. P.) : An official register of the deaths which occurred 
among the white population in the city of Savannah during the extra- 
ordinary season of sickness and mortality which prevailed in the 
summer and fall months of the year 1820; to which is annexed a list 
of the persons (as far as could be ascertained) who died out of the 
city after retreating from it. Also the aggregate amount of deaths 
among the people of color. 8°. Savannah, 1820. 



832 HISTORY OF YELLOW FEVER. 

Smith (H.) : Yellow fever at Savannah and Brunswick. Rep. Superv. 
Surg. Mar. Ho3p., Wash., 1878, p. 175. 

Stone (G. H.) : Yellow fever at Savannah, Ga. in 1876. Rep. Surg.- 
Gen., 1878, p. 107. 

Ward (John E.) : Reports to the City of Savannah for the year 1854, 
8vo. Savannah, 1854. 

Waring (W. R.): Report to the City Council of Savannah, on the 
Epidemic Disease of 1820. 8°. Savannah, 1820. 

White (O. A.) : Report upon yellow fever as it appeared in Savannah, 
Georgia, in 1876. X. York M.. J., 1877, vol. 25, p. 249. 

Woodhull (A. A.) : On the causes of the epidemic of yellow fever at 
Savannah, Georgia, in 1876. Am. J. M. Sc, Phila., 1877, n. s., vol.. 54, 
p. 47. 

White: May not yellow fever originate in the United States? An 
etiological study of the epidemic at Savannah in 1876. Trans. Pub. 
Health Assn., 1879, vol. 5, p. 107. 



ILLINOIS. 

CAIRO. 

1873. 

Infected by river boatmen from Memphis. New Orleans 
and intermediate points. 

On the 1st of September, two cases of yellow fever were 
received at the hospital from the steamer Mary Alice; 
on the 10th, two cases from the tow-boat B ; and on the 
24th, one case from the Keystone. Four of these cases 
were fatal, being in the stage of collapse when brought in. 
The fatal cases all had black vomit. 

The first fatal case among the citizens did not occur 
until September 13, when the cashier of the Illinois Cen- 
tral wharf-boat died. Then followed in rapid succession 
several other cases among persons employed in the same 
locality. Next, a man on Captain Phillips' wharf -boat 
sickened, and died on the fourth day. A colored woman, 
who did the washing of his clothing, took the disease and 
died one week after; and a child in the house where the 
nurse died, also took the disease, but recovered. 

There were in all 13 deaths out of 43 cases of yellow 
fever among the citizens, making, with the four deaths 
among those landed here with the disease, seventeen 
deaths from yellow fever between September 1 and Sep- 
tember 25. 

It was especially noted that the disease was confined to 
persons employed about the river and the localities above 
described; the four or five exceptions which occurred be- 
ing in the families of men who were thus employed. 

The disease did not make its appearance among the cit- 
izens until after the first two cases were received at the 
hospital from the steamer; and no new fatal cases oc- 
curred among citizens after the establishment of quar- 
antine. 



834 HISTORY OF YELLOW FEVER. 

1878. 

Infected by steamboats from "points below," as follows : 

On August 3, 1878, the steamboat Golden Grown an- 
chored in the riyer opposite Cairo ; was examined by the 
quarantine physician, and one case of yellow fever found 
on board. Two other cases of the disease were reported 
as being secreted on the boat at the same time. The 
steamer was not allowed to land. August 9, the steam- 
boat John A. Scudder passed Cairo for St. Louis, haying 
one case of yellow feyer on board, a refugee from New 
Orleans. On the 8th inst., Martin Alphen applied at the 
office of the Marine Hospital Service and stated that he 
shipped from this port, on the steamboat John D. Porter, 
the 27th of July; that he continued on the vessel till the 
6th inst., when he was taken sick, and returned to Cairo 
on the Dora Gable, which steamer met the Porter between 
Paducah and Cairo. He was sent to the hospital suffer- 
ing from what was supposed to be a form of malarial 
fever. On the third day after admission the disease was 
pronounced to be yellow fever, and in about two hours 
afterwards black vomit occurred in profusion, and the 
patient died three hours subsequently in convulsions. 

Lewis Clark arrived from Memphis, on the steamboat 
James B. Parker, on the 15th inst., and was taken ill with 
fever the same night at his mother-s house. The case re- 
mained without treatment until the 4th inst., and when 
medical attendance was procured, the case was past 
recovery. 

On September 4, four members of a family by the name 
of Porter, residing two miles outside of Cairo, on the 
banks of the Mississippi, were suddenly stricken with the 
fever. 

On the 8th, Mr. Thomas Nalley, the editor of the 
Cairo ''Bulletin," was taken ill with the fever and died 
on the 12th. 

Isaac Mulkey, an employe of the same office, died on 
the morning of the 13th. 

John Crafton and a man named Sullivan, both em- 
ployes of the ''Bulletin" office, becoming alarmed by the 



ILLINOIS CAIRO. 8S5 

death of Mr. Nalley, spent the night in a drunken 
debauch. The following morning, the 13th, Crafton ap- 
peared at the hospital as a private patient, and died on 
the afternoon of the 16th. Sullivan, on the morning of 
the 13th, went to Mound City, seven miles from Cairo, 
where he died on the 15th. 

On the 10th, Houston Dickey, age 18, was attacked and 
died on the morning of the 15th. 

On the morning of the 22nd, G. W. Craig was admitted 
to the hospital Avith well-marked symptoms of yellow 
fever. The man was a refugee from the South, had 
stopped at Clinton Station, Ky., and had engaged himself 
temporarily as a cook in a large boarding-house. He had 
also swept out some empty cars in which refugees had 
been brought from the South. As soon as he was taken 
sick he started for Cairo, crossing the river in a skiff 
during the night. 

On the 29th of September, in a family by the name of 
Petree, residing in the city, a daughter, age about sixteen, 
was taken ill with what was pronounced to be bilious 
fever, but finally proved to be yellow fever. The girPs 
mother had been taken sick shortly before, the exact time 
not being obtained. ' She and her daughter had been 
sleeping together previous to their illness. The mother 
died October 2, of yellow fever. 

Upon the same street as the ^'Bulletin" building, about 
two hundred feet distant, resided a Mr. Wilcox. This 
gentleman was of a very nervous temperment, and was 
greatly alarmed about the yellow fever. On the 21st of 
September he was seized with a chill, which was followed 
by high fever. On the 24th, he entered the hospital. The 
same evening his pulse stood at 112; temperature, 
102°; very much prostrated. A violent thunder storm 
came on later in the evening which greatly alarmed him, 
and soon after he sank into collapse. 

On October 10, Dr. Waldo was taken sick, admitted to 
the hospital, and, notwithstanding all care and attention, 
died the 18th. 



836 HISTORY OF YELLOW FEVER. 

It will be seen from the preeeding report that there 
were two centers of infection, one proceeding from the 
^^Bulletin'' building, where the editor died on the 12th. 
This district covered an area of about three city blocks 
in the heart of the city, and the yicinity of the custom- 
house. The other infected district was located in the 
upper part of the town, between 20th and 21st Streets, 
aud covered two or three blocks. 

From August 8, to September T, there were three cases 
of yellow fever and two deaths — all of them refugees. On 
September 7, the fii^st case among the inhabitants oc- 
curred, and from that date to November 5, inclusive, there 
were 51 deaths among the inhabitants. The total number 
of cases was 88. 

1S97. 

Four refugees from infected points in the South, had 
yellow fever in Cairo in 1897. There were only four cases 
with no deaths. The disease did not attack the in- 
habitants. 

CHICAGO. 

1878. One death, a refugee ^'from the South." 
1905. Week ending October 7, one death, a refugee. 

MOrXT CAE3IEL. 

1888. A fatal case, a refugee from Decatur. Ala. Sep- 
tember 25. 

PvOCKFOED. 

1888. One case, a refugee, from Decatur. Ala., Sep- 
tember 24, diea 29th. There was no spread of the disease. 

BIBLIOGRAPHY OF YELLOW FEVER IN ILLINOIS. 

Aimesse (J. W): Measures taken at Cairo, Illinois, to prevent the 
introduc'tion of 3-ellow fever. Ann. Rep. Sup. Surg.-Gen., 1906, p. 188. 
Annual Report State Board of Health of Illinois, 1S8S, pp. Ixi; Ixvi. 
Annual Report Sup. Sur.-Gen., 1873, p. 108. 



ILLINOIS. 837 

History of Yellow Fever at Cairo, 111. Ann. Rep. Sup. Surg.-Gen., 
1878-9, p. 149. 

Kallocli (P. C.) : Report of Yellow Fever occurring at Cairo, 111. 
Ann. Rep. Sup. Surg.-Gen., 1899, p. 668. 

Report Sanitary Commission of 1878. 

U. S. Pub. Health Reports, 1897, p. 1419. 

Ibid., 1905, p. 2754. 



INDIANA. 

INDIANAPOLIS. 

1878. Two cases, September 12, refugees ; one case died 
on the 17th. 

NEW ALBANY. 

1878. Cases on steamboat Mary Houston, from in- 
fected points. There was no spread of the disease. 



INDIAN TERRITORY. 

MAYSVILLE. 
1905. A fatal case, a refugee, September 1. 



KENTUCKY. 

BOWLING GEEEN. 

1878. First case, September 2. Cases, 42; deaths, 19. 
CLINTON. 

1878. 

Two cases of yellow fever occurred October 25. There 
was much excitement, and many citizens left the town 
in great haste. 

COVINGTON. 

. 1878. One case, a refugee from New Orleans. 

DANVILLE. 

1878. One case, September 3; died on the 9th. 

FILLMORE. 

1878. One fatal case, a refugee from New Orleans. 

FULTON. 

1878. Cases, 12; deaths. 5. 

HICKMAN. 

1878. Yellow fever was never epidemic in Hickman, 
until 1878. The first case was Charlie Hendricks on 
AugTist 13, supposed to have been infected on the 
railroad trains, as he peddled apples and mixed with 
passengers. He died August 16, on the 17th his little 
sister, Louisa, died, affected similarly; both had black 
vomit. No death until August 28, when Edward Mangel 



840 HISTORY OF YELLOW FEVER. 

died. Mrs. J. Witting died the 29th, Jimmie Young the 
30th, and numerous new cases continued to occur through- 
out the town. A panic ensued, scores were dead or 
dying, hundreds ill and over a thousand fled. Nearly all 
the local physicians died, four of the volunteer doctors 
died, 450 citizens were prostrated with the fever, 150 died. 
Date of the last death, November 6th. Total cases, 454 ; 
total deaths, 180. 

JOEDAN STATION. 

1878. Deaths, 2. 



1905. Cases, 2. 



LEXINGTON. 



LOUISVILLE. 



1873. First case, September 22; last case, October 15. 
Deaths, 5. 

1878. Population, 160,896. Early in the yellow fever 
season, Louisville opened her gates as a "city of refuge" 
from the raging disease. Thousands flocked from the 
South, many bringing the disease. On the 17th of August, 
3 cases of fever were sent to the United States Marine 
Hospital, from the steamer Sunflower Belle, 1 white and 
2 colored. On the 23rd of August, Mr. H. K. Davis, of 
the firm of Bryant & Davis, Grenada, came to Louisville 
and put up at the Waverly Hotel. In a few days he was 
stricken. Drs. Walling and Gaillard were summoned and 
later Dr. Luke Blackburn was called to see him ; he had 
black vomit and died on the 31st. A hearse was driven 
up the alley in the rear of the hotel and the coffin borne 
hurriedly away at midnight. When he was first taken 
ill, two nurses were employed. A young man, also from 
Grenada, who assisted in nursing, was also taken ill with 
fever, but recovered. On the 12th of September, Drs. 
Lloyd and Griffith were summoned to a refugee family 
on 33rd Street, and found 7 occupying a small room on 



KENTUCKY LOUISVILLE. 841 

the ground floor of an old frame house. Three children 
with yelloAV fever lay in one corner, the father in the 
other, and the mother, with a babe in arms, watching and 
nursing them. Conveyances were telegraphed for, and in 
a little while two hacks carried them to the yellow fever 
hospital, an infirmary which the city had erected and 
equipped for this disease early in the season. Mr. Lutz 
died September 25, on 11th Street near Maple, also two 
cases (colored) on Bible Alley. Meta Flynn, Nathanial 
Mudd, Wm. Shaw, Eddie Beirjmian, Mrs. Ryan and many 
others died of black vomit on or near Maple, Eleventh 
and Bible Alley, all being near the L. & N. R. R. depot ; 
but a diversity of opinion existed as to the disease. Some 
excitement arose. Three physicians, Drs. Bell, Yandell 
and Force, publishing a card endeavoring to allay excite- 
ment, caused a panic for a day or two, but the frightened 
ones were ridiculed out of their alarm, and returned. No 
case originated elsewhere in the city. Total cases, 12G; 
total deaths, 34. 

1879. Population, 175,000. A fatal case, a refugee 
from Memphis. 

1888. Population, 200,000. A fatal case, a refugee, 
September 19. 

1897. On August 14, 1897, a man came to Louisville 
from Ocean Springs, Mississippi, and was taken ill on his 
arrival. His case was diagnosed as yellow fever by the 
attending physician, who had lived in the South, and had 
clinical experience with the disease. The patient was 
immediately spirited away from the hotel, where he had 
been taken ill to a private sanitarium in the city, where 
he exhibited all the phenomena of yellow fever. He died 
on the 16th. He was quietly buried by the health author- 
ities. There were no developments from this case. 

At the time, there was no suspicion that yellow fever 
was prevalent in Ocean Springs, although ^'dengue" was 
said to be epidemic in the town. Nevertheless, the Louis- 
ville health officer immediately notified the health author- 
ities of New Orleans of the circumstances, naturally 
concluding that this city would be vitally interested in 



842 HISTORY OF YELLOW FEVER. 

investigating the '^suspicious cases," which had mani- 
fested themselves in Ocean Spring, and which had been 
diagnosed as dengue by the physicians. Acting on this 
information, and also alarmed by the fact that Dr. 
Theard, of New Orleans, had reported an unequivocal 
case of yellow fever in his practice, the President of the 
Louisiana State Board of Health, with members of his 
staff, went to Ocean Springs, made an investigation of 
the disease prevailing there. As a result of this tardy 
investigation by the health officers of New Orleans, the 
infection was brought to our doors and resulted in dis- 
astrous outbreak of yellow fever. 

MEDLEY'S LANDING. 

Only one case, that of a man who contracted the dis- 
ease while nursing his brothers at Hickman. 

TKENTON. 

1878. One death, a refugee. 

BIBLIOGRAPHY OF YELLOW FEVER IN KENTUCKY. 

Ann. Rep. Sup. Surg.<Jen., 1873, p. 109. 

Berry (T. D.): The Breeding of the Yellow Fever Mosquito at 
Louisville. Bulletin, Kentucky Medical Assn., vol. 1, p. 255 (1904). 

Brown (E. O.) : OflBcial report of piiy -ician in charge of the yellow 
fever hospital, Louisville, Ky., 1878. Louisville, Ky., 1878. 12p. 2 tab. 
8°. 

Brown (J. E.) : Yellow fever [Cloverport, Ky.]. Louisville M. 
News, 1878, vol. 6, p. 226. 

Dowell (G.) : Louisville, 1873. In his "Yellow Fever and Malarial 
Diseases," 1876, p. 39. 

Holland (J. W.) : Nature and source of the yellow fever at Louis- 
ville, Ky., in 1878. Am. Pract., Louisville, 1879, vol. 20, p. 352. 

Keating: History of Yellow Fever, pp. 43; 93; 25L 

McReynolds (J. O.): [Two cases of Yellow Fever at Trenton, Ky.]. 
Louisville M. News, 1879, vol. 7, p. 41. 

National Board of Health Bull., 1878-9, vol. 1, p. 45. 



KENTUCKY. 843 

Procter (J. R.) : Notes on the yellov^ fever epidemic at Hickman, 
Ky., during the summer and autumn of 1878. Frankport, 1879, B. H. 
Porter, 41 p. 2 pi. Imap. 4°. 

Procter (J. R.) : Notes on the yellow fever epidemic of Hickman, 
Kentucky, 1878. Rep. Bd. Health Ky., 1878-9, Frankport, 1879, vol. 1, 
p. 73. 4pl. 

Report Sanitary Coanmission, 1878. 

Thomas (R,. C): Yellow Fever in Southern Kentucky. Med. and 
Surg. Reporter, Phila., 1878, vol. 39, p. 523. 

Thomas (R. C.) : A history of the outbreak of yellow fever in 
Bowling Green, Ky., in 1878. Rep. Bd. Health Ky., 1878-9, Frankport, 
1879, vol. 1, p. 37, Ipl. 

Thompson (P.) : Yellow Fever in Kentucky. Rep. Bd. Health Ky., 
vol. 1878-9, p. 47. 

U. S. Pub. Health Rep., 1905, p. 2754. 

Ibid., 1897, p. 1419. 

Ibid., 1888, p. 219. 

Yandell (L. P.): The Late Yellow Fever Outbreak in Louisville. 
Louisville Med. News, 1878, vol. 6, p. 275. 

Yandell (L. P.): The Board of Health's Report on the Yellow Fever 
in Louisville. Louisville M. News, 1878, vol 6, pp. 239-241. 



LOUISIANA. 

ABITA SPKIIsGS. 

1905. Infected by New Orleans. First case, July 30. 
Cases, 4; no deaths. 

ALEXANDRIA. 

1819; 1822; 1827; 1831; 1837; 1839; 1847; 1853; 1854; 
1855, yellow fever years. No record of cases and deaths. 

1898. First case, October 6; last case, October 16. 
Cases, 200 ; deaths, 2. 

1905. First case, July 28. Cases, 21; deaths, 3. 

ALGIERS. 

A District of New Orleans^ which see. 

AMITE CITY. 

1898. First case, October 13; last death, October 13. 
Cases, 1 ; deaths, 1. 

ARCENEAUX PLACE. 

1879. First case, August 10. Cases, 1; no deaths. 

ASCENSION PARISH. 

1823. Locality not stated. No record of cases and 
deaths. 

AMELIA. 

1905. First case, August 8. Cases, 86; deaths, 5. 

AMESVILLE. 

1905. First case, July 25. Cases, 3 ; deaths, 1. 



LOUISIANA. 845 

ARDOYNE PLANTATION. 
1905. First ease, August 1. Cases, 200; deaths, 11. 

ATHERTON. 

1905. Cases, 8; deaths, 2. 

ATTAKAPAS CANAL. 

1879. Cases, 62; deaths, 18. 

BALDWIN. 

1905. First case, October 20. Cases, 1 ; deaths, 0. 

BAEATARIA. 

1905. First case, August 15. Cases, 56; deaths, 7. 

BATON ROUGE. 

1817; 1819; 1820; 1821. Yellow fever years. No 
records of cases and deaths. 
1822. Deaths, 60. 

1827; 1829. No record of cases and deaths. 
1829. Deaths, 7. 

1837. No record of cases and deaths. 
1843. First case, October. No statistics. 
1847; 1858. No record of cases and deaths. 

1878. Infected by New Orleans. First case, August 
10 ; first death, August 18. Cases, 2,435 ; deaths, 193. 

1897. Cases, 5; deaths, 2. 

1898. First case, September 25; last case, October 15. 
Cases, 176; deaths, 4. 

1905. First case, September 9. Cases, 8; deaths, 1. 

BAYOU BOEUF. 

1879. Population, 150. Infected by Morgan City. 
First case, September 5; first death, September 25; last 



846 HISTORY OF YELLOW FEYEA. 

case, NoYember 10; last death, Noyember 10. Cases, 77; 
deaths, 21. 

1905. First case, August 1. Cases, 15; deaths, 0. 

BAYOU BRULO. 

1905. First case, October 4. Cases, 40; deaths, 6. 

BAYOU CANE. 
1905. First case, September 3. Cases, 1; deaths, 0. 

BAYOU COOK. 

1905. First case, July 3. Cases, 2; deaths, 1. 

BAYOU CYPEEMORT. 

1878. Infected by Thibodaux, La. First case, Xoyem- 
ber — . Deaths, 7. 

BAYOU GOULA. 

1878. Deaths, 4. 

1905. First case, August 1. Cases, 17; deaths, 3. 

BAYOU XATCHEZ. 

1905. First case, September 3. Cases, 20; deaths, 6. 

BAYOU PLAQUEMINE. 

1853. First case, September 17; last case, September 
30. Cases, 9; deaths, 0. 

BAYOU SARA. 

1839; 1847; 1853. No record of cases and deaths. 
1878. Population, 700. Cases, 250; deaths, 13. 



LOUISIANA. 847 

BAYOU TEREEBONNE. 
1905. First case, September 4. Cases, 1; deaths, 0. 

BEL AMI. 
1905. First case, September 8. Cases, 106; deaths, 15. 

BELLE GROVE. 
1905. First case, August 31. Cases, 74 ; deaths, 12. 

BELLE HELENE. 
1905. First case, October 17. Cases, 2; deaths, 0. 

BELLESEIX PLANTATION. 
1905. First case, August 26. Cases, 43; deaths, 5. 

BELMONT. 
1905. First case, August 29. Cases, 1 ; deaths, 0. 
BERWICK CITY. 

1878. Population, 150. Infected by Morgan City. 
First case, September 27; last case, November 4; first 
death, October 7. Cases, 99; deaths, 7. 

1879. Population, 500. Infected by Morgan City. 
First case, September 8; first death, September 12; last 
case, December 1; last death, December 1. Cases, 75; 
deaths, 16. 

1905. First case, September 7. Cases, 1; deaths, 1. 

BIG BURNS. 

1905. Cases, 1 ; deaths, 0. 



848 HISTORY OF YELLOW FEVER. 

BLANCHARD. 

1S79. Cases, 1 ; deaths, 1. 

BOX AMI. 
1905. First case, August 6. Cases, 50; deaths, 8. 

BOXXET CARBE. 

1878. Several cases and deaths; no record. 

BOBGUEMOUTH. 
1905. First case, September 20. Cases, 1; no deaths. 
BOBODINO. 

1905. First case, September 21. Cases, 1; no deaths. 

BOWIE. 

1898. First case, October 6; last case, October 6. 
Cases, 1; no deaths. 

1905. First case, July 26. Cases, 1; deaths, 1. 

BBOUSSABD. 

1878. Deatlis, 1. 

BBULE SACBEMEXTO. 

1878. Deaths, 22. 

BUXKIE. 

1905. First case, July 20. Cases, 22 ; deaths, 8. 

BUBAS. 

1817. Sporadic cases. Xo statistics. 

1851. First case, September 22. Xo record. 

1878. Infected by New Orleans. Cases, 11 ; deaths, 3. 



LOUISIANA. 849 

CANAAN LANDTN(J. 

1878. Cases, 28; deatlis, G. 

CAROLINE LAND1N(}. 

1878. A fatal case in October. 

CARROLLTON. 

{A District of New Orleans^ ichich sec). 

CEDAR GEOVE. 

1905. First case, Seiotember 16. Cases, 2; deaths, 0. 

CENTEEVILLE. 

1853. First case, September 15; last case, November 
18. Cases, 45; deaths, 7. 

1855. First case, September — ; last case, October — . 

1879. First case, September 21 ; first death, September 
25; last case, December 4. Cases, 44; deaths, 14. 

CHALMETTE. 

1905. First case, September 30. Cases, 7; deaths, 0. 

CHENIERE CAMINADA. 

1905. First case, August 27. Cases, 62; deaths, 5. 

CHENIERE CANE. 

1878. No record. 

CINCLARE. 

1898. First case, October 15; last case October 25. 
Cases, 11 ; deaths, 1. 



850 HISTORY OF YELLOW FEVER. 

CLAEK CHENIEEE. 

1905. First case, July 16. Cases, 44; deaths, 3. 

CLINTON. 

1854. First case, September 1 ; last case, December — . 
1878. Infected by New Orleans. First case, Septem- 
ber 23. Cases, 96 ; deaths, 15. 

CLOUTIEEVILLE. 

1853. First case, August 14; first deaili, December 14. 

1854. No record. 

COLUMBIA. 

1878. Infected by New Orleans. First case, October 
3; last case, October 27. Cases, 2; deaths. 0. 

COOK'S LANDING. 

1878. Population, 35. Cases, 15; deaths, 4. 

COEINNE. 
1905. First case, July 20. Cases, 16; deaths, 4. 

COTE BLANCHE. 

1905. First case, August 18. Cases, 300; deaths, 51. 

COVINGTON. 

1847. Sporadic cases. No record. 
1905. Infected by New Orleans. First case, Septem- 
ber 23. Cases, 4; deaths, 1. All refugees. 

CRESCENT FAEM. 

1905. First case, August 30. Cases, 205; deaths, 1. 
It seems incredible that such a small mortality should 



LOUISIANA. 851 

have resulted, but the figures are ^'official," and we can do 
BO more than publish them. In our opinion, seventj-five 
per cent, of the cases reported as '^yellow fever" were erro- 
neously classified as such. 

CYPEEMOKT. 

1879. Infected by New Orleans. First case, October 
17 ; first death, October 25 ; last case, November 22. Cases, 
33; deaths, 9. 

DELHI. 

1878. Population, 500. Infected by Yicksburg. First 
case, August 11; first death, August 15. Cases, 164; 
deaths, 34. 

DELOGNY. 

1898. First case, October 1; last case, October 1. 
Cases, 1; deaths, 1. 

DELTA. 

1878. Population, 300. Infected by Yicksburg. First 
case, August 27; first death, September 2. Cases, 87; 
deaths, 47. 

1905. Cases, 60 ; deaths, 6. 

DES ALLEMANDS. 

1878. Population, 60. First case, i^ugust 20; last 
case, October 27 ; first death, August 24 ; last death, Octo- 
ber 30. Cases, 32; deaths, 17. 

DESLONDE. 

1879. First case, September 22. Cases, 40; deaths, 1. 

DIAMOND. 
1905. First case, August 16. Cases, 8; deaths, 0. 



852 HISTORY OF YELLOW FEVER. 

DIAMOND PLAXTATIOX 

1905. First case, July 20. Cases, 55; deaths, 10. 

DOXALDSOXVILLE. 

1827. No record. 

1839. Infected by Xew Orleans. Deaths. 15. 

1878. Population, 1,500. Cases, 481; deaths, 83. 

1905. First case, August 2S. 

DUXBOYXE. 

1878. Deaths, 5. 

EDGAED. 
1905. First case, September 11. Cases, 3; deatlis, 0. 

ELLEXDALE. 
1905. First case, August 30. Cases, 27; deaths, 2. 

EMPIEE. 
1905. First case, July 31. Cases, 1; deaths, 0. 

ESTELLE PLANTATION. 
1905. First case, September 5. Cases, 3; deaths, 0. 

EFEEKA. 

1878. Deaths, 1. 

EVEEETTE. 

1905. First case, September 16. Cases, 1; deaths, 1. 

EVEEGEEEN. 
1905. Cases, 2; deaths, 0. 



LOUISIANA. 853 

FISH lUVEE. 

1878. Xo record of cases and deaths. 

FLORENVILLE. 
1905. First case, September 3. Cases, 1 deatlis, 1. 

FOLEY PLANTATION. 

1879. First case, October 10. Cases, 4; deaths, L. 

FORT PIKE. 

1820. SiDoradic cases among soldiers. No statistics. 

FORT ST. PHILIP. 
1820. S])oradic cases among troops. No record. 

1905. Cases, 1; deal lis, 0. 

FRANKLIN. 

LSt)9. No record of cases and deatl:s. 

185B. First case, October IG; first deatli, October 23; 
last case, October 21; last death, October 25. Cases, 3; 
deaths, 2. 

1854; 1858; 1867. No record of cases and deaths. 

1897. Cases, 3; deaths, 1. 

1898. Cases, 607; deaths, 9. 

1905. First case, September 25. Cases, 5; deaths, 0. 

FRELLSIN. 

1906. First case, October 18. Cases, 1; deaths, 0. 

PREMEAUX. 
1879. First case, October 22. Cases, 2; deaths, 1. 



854 HISTORY OF YELLOW FEVER. 

FKENCH SETTLEMENT. 

1879. First case, November 19 ; last case, December — . 
Cases, 60; deaths, 5. 

GLENWILD PLA:NTATI0X. 
1905. First case, Sei^tembcr 15. Cases, 2; deatlis, 1. 

GOOD HOrE PLANTATION. 
.1905. First case, August 10. Cases, 23; deaths^ 1. 

GEAMERCY. 
1905. First case, September 1. Cases, 1; deaths, 0. 

GEAND ISLE. 
1905. First case, September L Cases, 71; deaths, 8. 

GEAND LAKE. 
1905. First case, July 25. Cases, 41; deaths, 7. 
GEEENWOOD. 

1873. Infected by Shreveport. First case, September 
29 ; first death, October 3 ; last death, October 29. Cases, 
19 ; deaths, 4. 

1905. First case, September 7. Cases, 1; deaths, 0. 

GEETNA. 

1878. Deaths, 53. 

1905. First case, September 22. Cases, 5; deaths, 2. 

GEOSSE TETE. 

1905. First case, September 2. Cases, 45; deaths, 5. 



LOUISIANA. 855 

HAHNVILLE. 

1878. Population, 200. No stai;sli(S. 

HAMMOND. 

1878. Infected hj Ozjka, Miss. First case, September 
18; first deatli, September 21; last death, November 1. 
Deaths, 5. 

IIARRISONBUEG. 

1878. Popiilalion, 275. Cases, 30; deaths, 10. 

HAPvVEY'S CANAL. 

1898. First case, Septemlicr 21; last case, October 6. 
Cases, 11; deaths, 3. 

1905. First case, September 1. Cases, 5; deaths, 0. 

HENDERSON. 

1878. Population, 400. First case, August 30. Cases, 
75; deaths, 18. 

HOUMA. 

1878. First case, October — . Deaths, 6. 
1898. First case, September 23; last case, October 5. 
Cases, 40; deaths, 2. 

1905. First case, August 30. Cases, 7; deaths, 0. 

JACKSON. 

1898. First case, October 15. Cases, 15 ; deaths, 0. 

JACKSON BARRACKS. 
1834. Deaths, 3. 



8.56 HISTORY OF YELLOW FEVER. 

JEFFEESOX PAEISH. 

1898. First case in September. Cases, 5; deaths, 0. 

JEAXEEETTE. 

1854. Xo record. 

1857. First case, October 7. 

JESUIT BEXD. 

1854. First case, September 12. 

1878. First case, September 22. Cases, 2; deaths, 2. 

KEMPA BEXD. 

1905. First case, September 17. Cases, 2; deaths, 0. 

KEXTWOOD. 

1905. First case, September 18. Cases, 2; deaths, 0. 

KEXXEE. 

1905. First case, Aiignst 18. Cases, 360; deaths, 33. 

LABADIEVILLE. 

1878. Population, 180. Infected by Xe-^' Orleans. 
First case, August 16 ; first death, August 21. Cases, 160 ; 
deaths, 24. 

LAFAYETTE. 

:!G05. First case, September 26. Cases, 4; deaths, 0. 

LAFOUECHE CEOSSIXG. 

1878. First case, September 12; last case, December 
18; first death, September 18; last death, December 21. 
Cases, 209 ; deaths. 26. 



LOUISIANA. 857 

1879. Infected by Morgan City. First ca^e, October 
2; first death, October 5; last case, December 1; last 
death, November 27. Cases, 40 ; deaths, 9. 

1905. First cace, August 26. Cases, 35; deaths, 5. 

LAKE CHAELES. 

1898. First case, October 10. Cases, 1; deaths, 0- 
LAGONDA PLANTATION. 

1878. Infected by NcAy Orleans. First case, Septem- 
ber 5 ; first death, September 10. Cases, 591 ; deaths, 42. 

LAKE PPvOVIDENCE. 

1853. Population, 1,000. Infected by New Orleans. 
First case, August; first death, August 31. 

1905. Firsf case, July 21. Cases, 327 ; deaths, 23. 

LAPLACE. 

1905. First case, August 16. Cases, 163; deaths, 18. 

LAROSE. 
1905. First case, August 29. Cases, 13; deaths, 5. 

LECOMPTE. 

1905. First case, September 11. Cases, 2; deaths, 0. 

LEEVILLE. 

( Lafourche Parish ) . 

1905. First case. May 24. Cases, 375; deaths, 67. 



858 HISTORY OF YELLOW FEYER. 

LOBDELL. 

3 898. First case, October 12; last case, October 12. 
Only case recorded. 

LOWER TEXAS. 
1879. Cases, 30; deaths, 7. 

LUCY. 
1905. I-'irst; case, October 5. Cases, 3; dealbs, 0. 

LUDINGTON. 
1905. Cases, 38 ; deaths, 0. 

LULING. 

1878. First case, September 15. Cases, 2 deaths, 0. 

LUTCHEE. 

1898. First case, October 15. Cases, 11; deaths, 2. 
1905. First case, August 11. Cases, 5; deaths, 0. 

MADISONVILLE. 

1905. First case, August 14. Cases, 1; deaths, 0. 

MALMOT. 

1879. First case, November 1. Cases, 1; deaths, 0. 

MANDEVILLE. 
1847. No record of cases and deaths. 



LOUISIANA. 859 

1878. Population, 300. Yellow fever made its appear- 
ance about the middle of September. A child died Sep- 
tember 26, and a few scattering cases followed. A young 
lady from New Orleans died next, and a Catholic priest 
died October 2. Deaths, 3. 

1905. First case, August 19. Cases, 2; deaths, 1. 

MANSUEA. 
1905. First case, November 10. Cases, 1 ; deaths, 0. 

MAKINGOUIK. 
1905. First case, Oct. 1. Cases, 1; deaths, O. 
MAEY PLANTATION. 

1879. Infected by Morgan City. First case, October 
10; first death, October 13; last case, December — ; last 
death, October 18. Cases, 45; deaths, 3. 

McDONOGHVILLE. 

1905. First case September 1. Cases, 20 ; deaths, 0. 
1858. No record of cases and deaths. 

MERAVILLE. 

1905. First case, September 16. Cases, 6; deaths, 0. 

MERKITT. 

1905. First case, September 16. Cases, 2; deaths, 0. 

MER ROUGE. 
1905. First case, September 16. Cases. 1; deaths, 0. 



860 HISTORY OF YELLOW FEVER. 

MILLAUDOX. 

1905. First case, September 8. Cases, 2; deaths, 0. 

MILLIKEX'S BEXD. 
1905. Cases, 27 ; deaths, 1. 

MOEEArVILLE. 
1905. Cases, 1; deaths, 0. 

MOKGAX CITY. 

1878. PcpiilaticD, 3,000. Infected hv New Orleans. 
First case, Augnstl7 ; last case, XoTember 10 ; first death, 
Auo'ust 22; last death, Xovember 11. Cases. 586; deaths, 

loo; 

1879. Poptilation, 3,000. First case, Jnlv 25: first 
death, August 16; last case, December 1: last death, De- 
cember 1. Cases, 89; deaths, 25. 

1905. First case, JuIt 28. Cases, 11 : deaths, 0. 

MOISE SETTLEMENT. 

1905. First case, August 30. Cases, 52 ; deaths, 3. 

XAPOLEON'YILLE. 

1878. PopiTlation, 500. Infected by Lafourche Cross- 
ing. First case, August 10. Cases, 3 •. deaths, 0. 

XATCHITOCHES. 

1839. Xo record of cases and deaths. 

1905. Xo record of cases and deaths. 

1905. First case, September 16. Cases, 1 ; deaths, 1. 

XEPiO. 
1905. Cases, 1. 



LOUISIANA. 861 

NEW IBEEIA. 

1839. No record of cases and deaths. 

1867. No record of cases and deaths. 

1870. No record of cases and deaths. 

1905. First case, October 10. Cases, 18: deaths, 1. 

1906. First case, August 19. Cases, 1. 

NEW IBEEVILLE. 
1905. Cases, 2; deaths, 0. 

NEW OKLEANS. 

Historical Kesume. 

The Birth of the City. 

In the spring of 1718, Bienville selected a site for fi 
town on the banks of the ^lississippi, and placed fifty 
men to clear off the grounds, as the location of the future 
capital of the province. The ground selected was that 
which is now covered by the lower portion, or French 
part, of the present City of New Orleans. The following 
spring, the river overflowed its banks, the new settlement 
was completed inundated, and the site seemed to present 
an uncertain location for a city, which remained for sev- 
eral years little more than a military post remote from 
the settlements. For three years Bienville's headquarters 
remained at Mobile. 

The historian. M. Le Page Du Pratz, who came over 
with a colonv of ei<>ht hundred men. in 1718, under the 
ausnices of tl^.e West India Comnany, states that six 
weeks before the arrival at Cape Francais, St. Domingo, 
fifteen, hundred persons died of an epidemic called the 
Siam Distemper. Du Pratz gives, however, nO' facts to 
show that any of the body of emigrants, some of whom 
settled at New Orleans and others at Natchez, suffered 
with yellow fever, for he states that after a passage of 



862 HISTORY OF \t:llow fever. 

three months, including the six weeks spent at Cape 
Francais, they arrived at the Island of Massacre, since 
called Isle of Dauphine, on August 25, after a prosperous 
Tojage, no one having died, or having been even danger- 
ously ill. Du Pratz describes the location of the future 
capital of Louisiana in 1718, as being marked out by a 
hut covered with palmetto leaves. 

As early as the year 1718, when Xew Orleans was 
founded, a company shij) had sailed from France with 
troops and one hundred convicts, destined for Louisiana, 
but had never been heard of. Toward the close of 1821, 
there arrived in Louisiana, a French officer who gave 
some account of this ill-fated vessel. It was now dis- 
covered that like the fleet of La Salle, she had missed the 
Mississipj)i, and had been driven to the west. Her com- 
mander had mistaken the island of Cuba for that of St. 
Domingo, and had been compelled to pass through the 
old channel to get into the gulf. He made a large bay, 
in the 29th degree of latitude, and discovered that he had 
lost his way. His misfortune was increased by a disease 
breaking out among the convicts. 

Five of the officers thought it less dangerous to land, 
with i)rovisions for eight days and their arms, than to 
continue on board. 

First Importation of African Slaves. 
The first importation of African slaves numbering 500, 
was made in 1719, a large portion of which was sent to 
New Orleans, and transferred to the west bank of the 
river to a plantation owned by a company. The re- 
mainder were sold chiefly to the agricultural settlements 
of the lower Mississippi. We have no accounts of any 
importation of yellow fever by these or subsequent cargoes 
of slaves under the French reign. 

The ^^Plagiie of Marseilles.'^ 

Benard de la Harpe states that on the 1st of Jnly, 1720, 

the king's ships, Le Comte de Toulouse^ sixty-four guns, 

commanded by M. de Vatel, after the death of M. de 

Cafaro, on the' 17th of June, and the Saint Henri, seventy 



NEW ORLEANS. 863 

guns, commanded by M. Douce, arriyed in Louisiana. 
They brought with them from the island of St. Domingo, 
a contagious fever or malady, which carried oft' a great 
number of persons every day. After opening several 
bodies, it was discovered that the disease came from a 
corruption which engendered a quantity of worms in the 
stomach. 

Francois Xavier Martin gives a wholly different ac- 
count of the origin and nature of this malady, and classes 
it with the Oriental Plague. He says: '^Two line-of- 
battle ships came in the latter part of June, 1720, from 
Toulon. They were in great distress ; Caffaro, the com- 
modore, and most of their crews had fallen to the plague, 
which some sailors in these ships who come from Mar- 
seilles, had communicated to the others; that city being 
ravaged by pestilence, brought there b}^ a ship from Lyde, 
in the Levant. Father Laval, a Jesuit, royal professor of 
hydrography in the colleges of Toulon, had by the king's 
order, taken passage on board this fleet, with directions 
to make astronomical observations in Louisiana. The 
chaplains of the ship having died, the father, considering 
science an object of minor consideration to a minister of 
the altar, thought it his duty to bestow all his time in 
administering spiritual relief to the sick, who for a long 
time were very numerous, and he sailed back with the 
ships. 

Origin of Slavery in Louisiana. 

Experiment having shown that Europeans could not 
stand the labors of the field, but sickened and died under 
the burning suns of Louisiana, and the chilling dews and 
fogs of night ; the Western Company was, therefore, com- 
pelled to introduce African negroes to cultivate the plan- 
tations scattered on the bayous and rivers of the delta 
of the Mississippi, and for several years it furnished the 
agricultural interests of the colony with several hundred 
annually, which was the origin of African slavery in 
Louisiana. In 1824, M. de Bienville drew up a code, con- 
taining all the legislation applicable to slaves in Louis- 



864 HISTORY OF YELLOW FKVKR. 

iana, wliicli remained in force nntil 1803. It appears that 
during the year 1781, Louisiana received no less than 
1,367 negroes from the coast of Africa. We have failed 
to discover in the writings of La Harpe, Du Pratz, Char- 
levois, Martin, Gavarre and others, any facts sustaining 
the view advanced by some, that yellow fever was first 
imported into Louisiana by the slave ships. 

Du Pratz, who visited Xe^^' Orleans and Biloxi in 1722, 
states that at the latter place more than five hundred 
persons died of famine. He states that ^'the great plenty 
of oysters found upon the coast saved the lives of them, 
although obliged to vrade up to their thighs for them, a 
gunshot from the shore. If this food nourished several 
of them, it threw numbers into sickness, which was still 
more heightened by the long time they were obliged to be 
in the water." 

Famines and Hurricanes. 

In the beginning of August, 1723, Bienville removed 
his headquarters to Xew Orleans. A most destructive 
hurricane desolated the province on the 11th of Septem- 
ber, 1723. The church, hospital and thirty houses were 
levelled to the ground in Xew Orleans ; three vessels that 
lay before it were driven onshore. The crops above and 
below were totally destroyed, and many houses of the 
planters blown down. Famine threatened the colonists 
with its horrors, but they were in some degree relieved 
by the appearance of an unexpected crop of rice. Dis- 
ease added iii the fall, its honors to those of impencHnfj 
death. 

In 1724, the white population of Louisiana, says La 
Harpe, amounted to aboutl,700 souls, and the black pop- 
ulation 3,300. If La Harpe 's statement be true, it shows 
an astonishing diminution of the white population, which 
in 1721, was computed at 5,400. 

An EarJij DeforestatiGn Edict. 

During the fall of 1726, Perrier, a lieutenant of the 
king's ships, having been appointed commandant general 
of Louisiana, shortly after, Bienville sailed for Finance; 



NEW ORLEANS. 865 

one of the articles of instruction to GoYernor Perrier ran 
thus: ^"WJio-eas it is maintained that the diseases tchiclv 
prevail i)i Xew Orleans daring the summer proceed froiw 
the leant of air, and from the city being smothered by the 
neighboring icoods, tchich jiress so close around it, it shall 
be the care of J/. Perrier to have them cut down, as far as 
Lake Pontchartrain/^ These instructions sho^^- That 
at that remote time, the summer was the sickly season at 
Xew Orleans, as it has continued ever since up to very 
recently ; and to make the city more healthy, the gov- 
ernment as far back as 1726, was struck with thq 
necessity of an improyement which was only finally ex- 
ecuted to fulfill the necessities of the Federal troops dur- 
ing their hostile occupation in 1863, 1861 and 1865. 

Colonial New Orleans. 

In the year 1727, the land of which the City of New 
Orleans now stands, not being protected by an adequate 
levee, was subject to annual inundations, and was a per- 
fect quagmire, presenting no better aspect than that of 
a vast sink or sewer. The waters of the Mississippi and 
those of Lake Pontchartrain, met at a ridge of high land, 
which by their common deposits they had formed between 
Bayou St. John and New Orleans, called the highland of 
the lepers. To drain the city, a wide ditch was dug on 
Bourbon Street, the third from and parallel to the river ; 
each lot was surrounded by a small ditch, which in the 
course of time filled up, except the part fronting the 
street, so that every square instead of every lot was 
ditched in. The whole city was surrounded by a large 
ditch, and fenced in with sharp stakes wedged close to- 
gether. In this way a convenient space was drained. In 
the language of Gayarre, ^'mosquitoes buzzed, and enor- 
mous frogs croaked incessantly in concert with other 
indescribable sounds; tall reeds and grasses of every 
variety grew in the streets, and in the yards, so as to 
intercept all communication, and offered a, safe retreat 
and places of concealment to venomous reptiles, wild 
beasts and malefactors, who protected bv these impene- 



866 HISTORY OF YELLOW FEVKR. 

trable juDgles, committed with impunity, all sorts of evil 
deeds.'' Is it any matter of surprise, therefore, that the 
hot months of summer and autumn were even at this early 
day, dreaded for their destructiye, x^estilential fevers? 



The First Levee. 

Governor Perrier signalized the beginning of his admin- 
istration, by the completion on the loth of Xovember, 
1727, in front of Xew Orleans, of a levee eighteen hundred 
yards in length, and so broad that its summit measured 
eighteen feet in width. This same levee, although con- 
siderably reduced in its proportion, he caused to be con- 
tinued eighteen miles on both sides of the city above and 
below. He announced to the company that he would soon 
undertake to cut a canal from Xoav Orleans to Bayou St. 
John, in order to open a communication with the sea^ 
through the lakes, and he mentions the arrangements 
which he had made with the inhabitants in relation to the 
negroes they were to furnish for the execution of this 
work, which was actually begun, but to which subsequent 
events put a stop. Thus it is seen that the plan of the 
canal which now bears the name of Carondelet, did not 
originate with the Spanish governor. 



Pestilence^ Famine^ Drouths and Hurricanes. 

From a dispatch of Diron d'Artaguette, dated April 
23, 1733, we learn that small-pox was then raging in 
Louisiana, and that from this cause and famine, the 
result of the destruction of the crops by a hurricane, the 
colony Avas on the eve of being depopulated. 

Bienville and Salmon, in a joint dispatch of the 31st of 
August, 1735, say : ''The mortality of cattle is frightful, 
the drought is excessive and the heat is suffocating. Such 
hot weather has never been known since the foundation 
of the colony, and it has now lasted four months without 
anv change.'' 



NEW ORLEANS. 867 

The ''Mad Docf Epidemic. 

While the j^lanters were suffering from drought, after 
having suffered from inundations, the inhabitants of New 
Orleans were laboring under a strange kind of infection. 
They could hardly venture out of their houses without 
being bitten by mad dogs. These animals had increased to 
such an extent, that the^^ had become an intolerable 
nuisance, and to remedy the evil, the royal commissary, 
Salmon, ordered them to be hunted down, on certain days, 
from tive o'clock to six o'clock in the morning. He also 
prohibited negroes and Indians from having dogs, under 
the penalty for the offender of being sentenced to wear 
an iron collar. 

Festilence More Fatal than War. 

In 1731, Bienville was reappointed Governor of 
Louisiana. 

The force which Bienville assembled in 1739, for the 
subjection of the Chickasaw Indians, consisted of up- 
wards of 1,200 white, and double that number of Indian 
and black troops. This comparatively large army, un- 
accountably spent six months in making i:>reparations for 
its march. In the meanwhile, the troops lately arrived 
from France became unhealthy, and many died, and the 
climate had an almost equallj^ deleterious intiuence on 
those from Canada. Early the next fall, the regulars and 
militia of Canada and Louisiana, who had escaped the 
autumnal disease, were prostrated by fatigue, and Bien- 
ville was compelled to confine his call for service, to his 
red and black men. They were his only effective force. 
In the Chickasaw war, peace was purchased at the price 
of many valuable lives — estimated at 500, out of 1,200 
white troops, not slain in battle, but destroyed by the 
fevers of the climate. 

Cession to ^pain. 

On the third of November, 1763, a secret treaty was 
signed at Paris, between the French and Spanish Kings, 



868 HISTORY OF YELLOW FEVER. 

by wliich tlie former ceded to the latter, the part of the 
province of Louisiana which lies on the western side of 
the Mississippi, including the City of Xew Orleans. 

The subsequent history of New Orleans, including the 
cession to the United States and other political events, 
is well known to the majority of our readers. This re- 
sume, taken from the memoirs of the late Joseph Jones, 
one of Louisiana's most distinguished surgeons and 
authors, '^■overs the most interesting period in the life of 
the beautiful metropolis of the South. 

Summary of Epidemics.* 

According to Chaille (Xeic Orleans Medical and Sn?^- 
fjical Journal, 1858, p. 818), there is authority for stating 
that cases of yellow fever occurred in New Orleans in 
1769 and 1791 ; other authorities assert the fever was also 
present in 1793, 1791 and 1795 — but the first unquestion- 
able epidemic did not occur until 1796, at which time the 
city had a population of about 6,000. 

The yellow fever years in Xew Orleans, from 1769 to 
the last epidemic (1905), may be summarizeel as follows: 

1769. First traditional appearance of yellow fever in 
New Orleans. No statistics. 

1791 ; 1793 ; 1791. Xo record of cases and deaths. The 
digging of the Carondelet Canal (Old Basin) was begun 
inl791. 

1795. Limited outbreak. 

1796. First autlientic invasion of New Orleans by yel- 
low fever. Xo reliable statistics obtainable. 

1797. Xo record of cases and deaths. The Old Basin, 
the present head of the Carondelet Canal, was excavated 
in 1797 

1799. No record of cases and deaths. Crevasse above 
the city. ' 

1800^^; 1801 ; 1802 ; 1803 ; 1801 ; 1809 ; 1811. No record 
of cases and deaths. Hurricane, doing much damage lo 
city, in 1811. 

i812. Population, 19,229. War with Great Britain. 

* Dates of important excavations, etc., are given because of their 
fanciful association, at the time, with yellow fever out- 
breaks. 



NEW ORLEANS. 869 

1817. Population, 21,196. Infected by British Cutter 
Phoenix, from Hayaua. First case, June 18; last death, 
December — . Deaths, 80. Extensive crevasse above city 
the 3'ear previous. 

1818. Population, 25,190. Mild epidemic. Deaths, 115. 

1819. Population, 26,183. Infected by Havana. 
Severe epidemic. First case, July 1. Deaths, 2,190. 

1820. Population, 27,176. First case, July — . That 
year, the Avooden sidewalks in the business portion of the 
city were removed and bricks or flags substituted. 

1821. Xo record of cases and deaths. 

1822. Population, 31,706. First case, September 1. 
Cases, 337 ; deaths, 237. 

1823. Population, 33,971. Infected by Pensacola. 
First case, August 23. Cases, 2,337 ; deaths, 239. 

1824. Population, 36,236. Infected by Havana. First 
case, August 4. Cases, 167; deaths, 108. 

1825. "Population, 38,501. First case, June 23. Cases, 
99; deaths, 49. Digging of Gormeley's Canal to drain 
upper part of city. 

1826. Population, 40,766. First case, May 18. Cases, 
24; deaths, 5. Digging of Melpomene Canal. 

1827. Population, 43,031. First case, July 19. Cases, 
372 ; deaths, 109. 

1828. Population, 45,296. First case, June 18. Cases, 
290; deaths, 150. 

1829. Population, 47,561. First case. May 23. Cases, 
435 ; deaths, 215. 

1830. Population, 49,826. First case, Julv 15. Cases, 
256 ; deaths, 117. 

1831. Population, 52,455. First case, June 9. Cases, 
3; deaths, 2. 

1832. Population, 55,084. First case, August 15. 
Cases, 26 ; deaths, 18. 

1833. Population, 57,713. First case, July 12. Cases, 
422; deaths, 210. Heavy rains, lasting from June to 
September. 

1834. Population, 60,342. First case, August 28. 
Cases, 150 ; deaths, 95. 



870 HISTORY OF YELLOW FEVER. 

1835. Population, 6,2,971. First case, August 23. 
Cases, 505; deaths, 284. 

1836. Population, 65,600. First case, August 21. 
Cases, 6; deaths, 5. 

1837. Population, 68,229. First case, July 24.. Cases, 
998 ; deaths, 112. 

1838. Population, 70,858. First case, August 25. 
Cases, 22; deaths, 17. 

1839. Population, 73,137. First case, July 23. Cases, 
1,086; deaths, 152. 

1810. Population, 76,116. First case, July 25. Cases, 
3; deaths, 3. 

1811. Population, 78,715. First case, July 27. Cases, 
1,111; deaths, 591. Drainage Ccmmissicn actiyely en- 
gaged in drainage and clearing. 

1812 Population, 81,371. First case, July 30. Cases, 
425 ; deaths, 211. 

1813. Poptilation, 81,003. First case, July. Cases, 
1,096 ; deaths, 187. 

1844. Population, 86,632. First case in July; last 
case, September. Cases, 169 ; deaths, 83. Qyerflow from 
Lake Pontchartrain ; city flooded to Burgundy Street. 

1815. Population, 89,261. Deaths, 2.^ 

1846. Population, 102,070. First case in August ; last 
case in October. Deaths, 116. Faubourg Lafayette an- 
nexed to city, increasing population. 

1847. Population, 108,699. First case, July 6; last 
case in December. Deaths, 2,306. War with Mexico. 
Melpomene Canal cleaned out. Heayy rains. 

1818. Population, 115,503. First case, June 21 ; last 
case in Xoy ember. Deaths, 808. Extensiye excayations 
made for foundations of United States Custom-house. 
This work went on uninterruptedly until September, 
1819. Two acres, 20 by 7 feet wide and 8 feet, 7 Inches 
deep, were excayated. 

1819. Population, 122,511. First case, July 28; last 
case, December — . Deaths, 769. 

1850. Population, 129,717. First case in January, 
terminating fatalh^; 2 deaths in March, 1 in May, 4 in 



NEW ORLEANS. 871 

Jul}', ()2 in Aiio'ust, 33 in September and 4 in October. 
Total deaths, 107. 

1851. Population, 138,599. Deaths, 17. Excavations 
for railroads, gas and waterworks. 

1852. Population, 117,411. First case, Jul}- ; last case, 
December — . Deaths, 15G. Claiborne Canal dug. 

1853. Population, 151,132. Infected by ship Camhoden 
C(i.<;fJc, from Kingston, Jamaica. First case. May 22; 
last case, December. Deaths, 7,819. 

The epidemic of 1853 was the most mortal which has 
ever afflicted New Orleans. 

1851. First case. May ; last case, December ; first death, 
June 12. Deaths, 2,125. 

1855. First case, June 19; last case, December. 
Deaths, 2,670. 

185G. Population, 153,121. Infected by Vera Cruz. 
First case, June 28 ; last case, Noyember — . Deaths, 74. 

1857. Population, 157,242. Infected by Havana via 
Mobile. First case, January; last case, December. 
Deaths, 200. 

1858. Population, 161,633. Infected by St. Thomas, 
West Indies. First case, June 10; first death, June 
10 ; last case, October 10. Deaths, 4,845. 

1859. Population, 164,864. Infected by brig Elizabeth 
EIku, from Havana. First case, June — . Deaths, 91. 

1860. Population, 168,675. Deaths, 15. 

1861. Population, 170,949. Civil War. No cases. 

1862. Infected by Key West. Deaths, 2. 

1863. Population, 175,197. Deaths, 2. 

1864. Population, 177,708. Deaths, 6. 

1865. Population, 180,943. Cases, 1 ; deaths, 1. 

1866. Population, 182,318. First case, August 10. 
Deaths, 185. 

1867. Population, 181,503. First case, June 10; last 
case, December 22. Deaths, 3,107. 

The first case died in the Charity Hospital on June the 
10th, a seaman who had been emploj-ed in the navigation 
of the Lake. Three weeks before his death he had shipped 
upon the bark Bessie, loading with staves in the Fourth 



872 HISTORY OF YELLOW FEVER. 

District, and bound for Barcelona. This vessel had sailed 
from Hayana in March, arriving here in April laden with 
sugar. She was reported clean and healthy. Soon after 
arriving, went into dry dock in Algiers. Inquiries were 
made as to her after her sailing. She arrived at her desti- 
nation without mishap as to the lives of her crew. 

The second case re^Dorted was by Dr. Brickell, as hav- 
ing been taken on the 13th of June, on St. Charles Street 
near Julia. The man, John Boddis, recovered. 

The third case, reported by Dr. Folwell, on Julia Street, 
between Camp and St. Charles Streets, died on the 23rd 
ol' June. 

The fourth case died on the 26th of June. His name 
was J. B. Bonnonan. He arrived upon the steamer W. G. 
Hewes, from Galveston, on the 21st, whence he came from 
Indianola direct. He had a chill at Galveston on the 19th 
and died on the 26th. 

The fifth case, J. Dougherty, reported by Dr. L. H. 
Cohen, died on the 29th of June in the Charity Hospital. 
He came from No. 61 Girod Street, and was employed on 
coal barges at Algiers. 

The sixth case was Lieut. Dewey, who died at the St. 
Charles Hotel. He came by steamer direct from Indian- 
ola, and was brought from the vessel to the hotel sick. 

The vessel coming to this port, clearly infected, was 
the bark Florence Peters^ which sailed from Havana on 
the 3rd of June laden with sugar. She was stopped at 
the Quarantine Station, June the 12th, where she was 
detained ten days, although reported clean and healthy, 
was fumigated and released. She arrived at Algiers, June 
22. The wife of the captain, Mrs. Hooper, died of yellow 
fever on the 30th. This case was reported by Dr. Bruns. 
Her sister also was attacked on the 25th, but recovered. 
The second mate (Thomas) was taken ill July 4, and 
died in the Charity Hospital on the 9th. The captain also 
died on the 13th. ^ 

The fever existed throughout July in the city, and until 
near the middle of August before acquiring epidemic 
proportions. 



NEW ORLEANS. 873 

From the middle of August to the end of September, 
the mortality was considerable. 

1868. Population, 186,068. First death, October 5. 
Deaths, 5. 

1869. Deaths, 3. 

1870. Infected by steamship Agnes, from Honduras. 
First case, May 16; last case, December. Deaths, 588. 

1871. Infected by brig Mary Pratt, from Cuba. First 
case, August 4; last case, October. Deaths, 54. 

1872. First case, August 28; last case, November 30. 
Deaths, 39. 

1873. Infected by bark Valparaiso, from Havana. 
First case, July 4; last case, November 19; first death, 
July 8. Cases,'^368; deaths, 226. 

1874. 

The outbreak of 1874 is interesting, from a point of 
high rate of mortality, considering the limited number of 
cases. There were altogether 20 cases, of which 17 died. 
The first two cases were discovered by the Board of 
Health on the same day (August 19) at Xo. 470 Victory 
Street, in the persons of two Irish boys, aged 6 and 9, 
who had only been in the city six months. Yellow fever 
had been quite severe in that block the year previous 
(1873). The little patients died. On August 25, the 
mother of the tots, aged 30, contracted the disease and 
died shortly afterward. The other cases occurred as 
follows : 

September 21— Xo. 102 Front Levee Street— Died. 
September 22— Xo. 459 Julia Street— Died. 
September 23 — X^o. 147 Magnolia Street — Died. 
September 26 — X^o. 10 Dumaine Street — Died. 
September 29— Xo. 619 Goodchildren Street— Died. 
October 4— Xo. 390 Magazine Street— Died. 
October 7 — X^'o. 169 Baronne Street — Eecovered. 
October 8 — X^^o. 412 Magazine Street — Died. 
October . .— Xo. 102 Old Levee Street—Died. 
October . . — Unknown — Died. 



874 HISTORY OF YELLOW EEYER. 

October 15 — Xo, 15 Eonsseaii Street — Died. 

October 17 — Xo. 95 Spain Street— Eecovered. 

October 21 — Xo. 163 Orleans Street — Died. 

October 22 — Xo. 619 GcodcMldren Street — Died. 

XcYember 1 — Bark Queenstoicn — Eecovered. 

XoTember 2 — Bark Qucensfoioi — Died. 

XcTeniber 2S — Chartres Street — Died. 

According to tlie records of the Board of Health (1874), 
the fourth case occurred in the same sqtiare where yellow 
fever had prevailed the year before. Cases 5, and 6 were 
infected at Pascagotila, Miss., and cases 18 and 19 were 
imported from Havana by the bark Queenstoicn. 

1875. First case, August 8; first death, Angnst 12; 
last case, Xcvember 28. Cases, 100 ; death-;, 61. 

1876. Deaths, 11. 

1877. The history of yellow fever for the year 1877, 
in Xew Orleans, is limited to a single case. A man ar- 
rived on the steamsh'p St. Louis, from Havana, Xovember 
6, and died the next morning at the corner of Eousseau 
and Philip Streets, with nnmistakable sym^ptoms of yellow 
fever. He had sickened fonr days previously, within a 
few hotirs after leaving Havana, where he had stayed 
three weeks; but contintied to go about the ship until 
after passing the quarantine, and in this way failed to 
attract the attention of the resident physician. 

1878. 

This is one of the most notable epidemics of yellow 
fever in the history of Xew Orleans, owing to the numer- 
ous places which were infected from this focus. 

On May 22, 1878, the ship EniiJij B. Souder arrived at 
quarantine below Xew Orleans, having called at Havana 
during her trip. Upon her arrival. Dr. Carrington, the 
quarantine officer, after making an examination, tele- 
graphed Dr. Choppin, President of the Louisiana Board 
of Health, as folloAvs : 

''The Souder has a case of intermittent on board. 
AYhat shall I do?" 



NEW ORLEANS — 1878. 875 

Dr. Clioppin replied: 

''Fumigate and disinfect the ship and satisfy yourself 
of the character of the disease before you let her come 
up.'' 

The sick man was placed in the quarantine hospital 
and finally recovered. 

The Soiider after five hours' detention, and disinfection 
with sulphur burned in pans, was permitted to go up to 
the city.* 

Soon after arrival at her wharf, Mr. Clark the 
purser, was taken ill, and Dr. Drew, of Pilot Town, who 
had taken passage at that point, was called to treat the 
case. The physician did not consider this a case of yel- 
low fever, as he signed the certificate of death, ''Malarial 
fever." An investigation of the case at the house where 
he died, however, showed that the treatment was more 
suitable to yellow fever than to any other disease. This 
death was not brought to the notice of the Board of 
Health by any direct communication, official or otnerwise, 
• but from information received through rumor. It is a 
significant fact in connection with Clark's case, that he 
died at 2 o'clock, a. m., and was buried at 10 a. m., the 
same day. No public announcement of his death v.*c:lV 
made until the following Sunday. 

Mr. Elliott, the second engineer of the louder, was 
taken sick shortly after his arrival, and was attended by 
a private physician at his boarding-house, corner of Front 
and Gircd Streets, until the evening before his death, 
without apparently a suspicion on the part of any one 
that he had yelloAV fever. Late in the evening of May 29, 
he was removed to Hotel Dieu, where he died within a 
feAV hours. A careful post mortem examination was 
made by two competent physicians, and the body was sub- 
sequently inspected by Dr. Chopi3in. No one of these 
physicians doubted the nature of the disease. 

For about two months after the above occurrences, no 

* Detention of passengers in quarantine, for observation, 
abolished by Legislature of 1876 and reliance placed on 
disinfection alone. 



876 HISTORY OF YELLOW FEVER. 

new cases developed. If yellow fever existed, it was not 
reported to the Board of Health, or was of such a mild 
nature as not to be differentiated from the malarial fevers 
common in those days. 

About the middle of July some cases of a strongly sus- 
picious character came to light on Constance Street, near 
its intersection with Terpsichore, and in a few days all 
doubt was removed of their true nature. About the Tth 
of July, a young man, named Cohn, came to the Touro 
Infirmary from Gasquet Street, between Yillere and 
Marais, presenting strong appearances of yellow fever, 
but he recovered before attention was drawn to Constance 
Street, and his case was considered questionable. Within 
a few days, cases were found near the corner of Front 
and Girod, where Elliott had sickened ; on Bienville, near 
where Clark had died and on Claiborne Street; a case 
on Robertson Street, near the home of Cohn, who had 
been at the Touro Infirmary, not much more than a quar- 
ter of a mile from Avhere Clark died, and a still less dis- 
tance from Hotel Dieu, where Elliott died. 

The line of infection was tolerably clear, though long 
latent, from Clark to Cohn and subsequently to the cases 
on Bienville and Robertson Streets; also from Elliott, 
sick at his boarding-house, to the subsequent outbreak at 
the corner of Front and Girod; but the outbreak on Con- 
stance Street was so far from the wharf of the louder 
(fully half a mile), and so long after her arrival (more 
than six weeks), that it was long considered out of ques- 
tion to establish a connection between them. 

Investigations made afterward by the Board of Health, 
showed that seme of the earliest cases on Constance 
Street, 122, occurred in the family of a Mr. Caven, who 
was engineer on the tugboat Charlie ^Yoo(l. This boat 
lay at the same vrharf occupied by the louder, immedi- 
ately after the departure of the latter for Havana, as 
stated by Caven himself at the time of his illness. 

On July 21, the following communication was sent : 



NEW ORLEANS 1878. 877 

New Orleans, July 24, 1878. 
Dr. J. M. WoodAvortli, Surgeon-General, 

Marine Hospital Service, AVashington, 1). C. i 
Sir — It now becomes my duty to report the existence, 
of yellow fever in Ncav Orleans. About the 12th inst., 
cases began to occur in the practice of several of our 
physicians near the intersection of Constance and Terp- 
sichore Streets, which j^resented suspicious symptoms, 
and we now reckon fourteen cases at that focus of in- 
fection, with six deaths. In addition to those, seven other 
cases have come to light at different points, and much 
more scattered, four of which have already resulted 
fatally. 

Respectfully, your obedient servant, 

Samuel Choppin^ M. D., 
President, Board of Health. 

Early in August the fever began spreading rapidly 
through the city and vicinity, and throughout all of Sep- 
tember and most of October, raged furiously, attracting 
by its terrible death roll, the attention of this and many 
foreign nations. From all quarters, physicians, nurses 
and supplies came, but not until late in November did 
the demon of pestilence finally make his exit from the 
unfortunate city. 

This memorable epidemic may be briefly summarized 
as follows : 

Population of New Orleans in 1878, 210,000. Infected 
by ship Emily B. Soitder, from Havana. First case. May 
22 ; first death, Mav 25 ; last case and death, December 12. 
Gases, 27,000 ; deaths, 4,046. 

1879. First case, March 26, on board steamship Balti- 
more^ recovery. No other manifestation until June, when 
the first case in the city proper occurred at No. 184 Third 
Street, and was reported by Dr. Edmond Souchon. The 
first death took place on July 27, corner Second and Gon- 
stance Streets. The epidemic lasted until October, last 
case on the 21st and last death on the 23rd. Gases, 48; 
deaths, 19. 

1880. Deaths, 2. 
1883. One death. 



878 HISTORV OF YELLOW l-EVER. 

1889. 

One fatal case, imported from Liyingston, Guatemala^ 
under the following circumstances : 

Mr. E. DeYilla, United States consular agent for the 
United States of Colombia, had been at Guatemala City, 
and from there went overland to Livingston, Guatemala, 
where he took passage on the steamship City of Dallas 
for New Orleans, on the 26th of September. The second 
day out he was taken with a chill followed by fever, but 
did not keep to his berth after the chill. He continued 
to feel ill during the voyage, but before arrival of the 
vessel at the Mississipi)i quarantine, he dressed himself 
and went on deck, thus passing inspection by the quar- 
antine officer. The master of the vessel made affidavit 
that there had been no one sick during the voyage. The 
vessel had a clean bill of health, and there being no report 
of yellow fever at Livingston, the vessel, after being dis- 
infected, was allowed to proceed to Xew Orleans, where 
she arrived at 8 p. m., October 1. 

The patient was seen by Dr. J. J. Castellanos, October 
2, had had fever, nausea, hiccough, pain in the region of 
the stomach, and bilious vomiting. When seen again at 
night he was vomiting black vomit, followed by black 
hemorrhagic stools. The next morning, black vomit still 
persisted and he had urinary suppression, hicocugh and 
ur^emic convulsions. 

Dr. Castellanos reported the case to the Board of Health 
office, and a commission of experts, com^Dosed of Drs. 
J. P. Davidson, C. J. Bickham and George Howe, was 
summoned and requested to see the case and pass upon it. 

In the mean time the man had died (October 3, 11:35 
a. m.), and at 2 p. m. the above named physicians, with 
Dr. Castellanos and Dr. E. Matas, who had been called 
in consultation, proceeded to the house, No. 119 Decatur 
Street, and after obtaining a history of the case and hold- 
ing an autopsy, unanimously declared that death had 
benn caused by yellow fever. 

There were no developments from this case and the 
city continued to be free from epidemic disease during 



NEW ORLEANS. 879 

the eight following years, and would undoubtedly haye 
enjoyed a longer immunity but for infection from out- 
side sources in 1897. 

1897. 

The first authentic case of yellow feyer in Xew Orleans 
in 1897, was reported by Dr. Sidney L. Tlieard, on Sep- 
tember 1th. The biennial report of the Louisiana State 
Board of Health for the years 1896-97, published in Feb- 
ruary, 1898, recounts that an earlier case had been re- 
ported as suspicious on September 1st, by a prominent 
physician of N^w Orleans (Dr. E. T. Shepard), which, 
on inyestigation by members of the Commission of Ex- 
perts of the State Board of Health, had been declared 
not to be yellow feyer. Of this, howeyer, no one had any 
knowledge at the time except those immediately connected 
with the public health seryice. Dr. She^Dard's case ended 
in recoyery. 

The case of feyer in Dr. TheaicVs practice was reported 
by him to the Secretary of the State Board of Health, on 
Saturday, September 1, (1897), at 3 o'clock p. m. ; the 
President of the Board haying left that same eyening for 
Ocean Springs, to again inyestigate the preyailing feyer 
at that point, belieyed to be dengue.* ; 

Dr. Theard, haying been engaged in practice about six! 
years only, had had no occasion to see yellow feyer, the 
last epidemic of that disease haying occurred in 1878, 
and only had a book-knowledge of the disease. For that 
reason two members of the Commission of Yellow' Feyer 
Experts were delegated to consult with him. The patient 
was seen that same eyening at 8 p. m., and the case pro- 
nounced to be one of malarial hemorrhagic feyer. 

A prolonged search was made the next morning by Drs. 
Theard and Pothier, the latter a distinguished pathologist, 
for malarial organism in the patient's blood, but none 
found. 

* Previous investigations of the fever at Ocean Springs by the 
State health officials of Mississippi, Alabama and Louisiana, 
had resulted in a diagnosis of dengue fever. 



880 HISTORY OF YELLOW FEVER. 

On Monday morning the patient (Eaoul Gelpi) died, 
and Dr. Tlieard notified the secretary of the Board of 
Health, by phone, that he would be down in person at 
the Board of Health office to sign the deatli return, and 
would ascribe the death to yellow feyer. On his arriyal 
there, shortly afterward, he found a number of physicians 
in waiting, seeking news about Ocean Springs, among 
them one of the experts who had seen the case on behalf 
of the Board of Health, and who was still of so strong a 
mind that the case was malaria that he offered to sign 
the death certificate as such. This Dr. Theard would not 
accept, unshaken in his own diagnosis of yellow feyer. 

Happening to enter the office of the Board of Health 
about this time. Dr. F, W. Parham, upon being made 
familiar with the facts in the case and the wide diyergence 
of yiews of the experts and medical attendant, suggested 
the adyisability of an autopsy under the circumstances, 
so that nothing could be left to opinion or conjecture. 
Pending a post mortem inyestigation, a telegram was sent 
to the President of the Board of Health, adyising him of 
the facts. 

An autopsy held at 10 oclock a. m., by Drs. Pothier, 
Touatre, Salomon, H. S. Olliphant, Parham and Theard, 
confirmed, beyond question, the latter-s diagnosis of yel- 
low feyer. 

The announcement of yellow feyer shocked the commer- 
cial spirit of the community. It was a rude awakening 
for IN'ew Orleans after nineteen years of uninterrupted 
prosperity and freedom from epidemic disease, and seyere 
and bitter criticism was directed at Dr. Theard from 
many quarters in consequence. 

The date of report of this case is important in that the 
patient hailed from Ocean Springs, then under inyesti- 
gation, and that trainloads of persons who returned from 
the Gulf Coast resorts on Sunday, September 5th, would 
not haye been permitted to enter New Orleans, had Dr. 
Theard's opinion preyailed on Saturday, September 4. 

Nineteen hundred and eight cases of feyer were reported 
in 1897, with 298 deaths, the last case being reported on 
December 25. 



NEW ORLEANS. 881 

1898. 

One fatal ease in January. No cases Avere reported 
until September 17, when a death from yellow fever cre- 
ated consternation in the community. Cases continued 
to occur until October 22, when frost put an end to the 
activities of the Stegomyiae. Cases, 118 ; deaths, 57. 

1899. 

According' to the Annual Report of the Louisiana State 
Board of Health for 1898-99 (p. 46), the first case of 
yellow fever was reported on May 28, in the person of a 
young, white girl, residing at 1217 Eoyal Street, Second 
District, 

On August 28y a second case was reported at 4520 Camp 
Street, in the Sixth District, fully three miles distant 
from the original case. 

A third case was reported September 1, and a fourth 
on the 7th. Sporadic cases continued to erupt up to 
November 15, on which day the last case was reported. 

The most searching inquiry failed to reveal the source 
of the primary infection. Cases, 81; deaths, 23. 

1905. 

The epidemic of 1905 is memorable in many ways, but 
what has stamped it indelibly in the minds of the great 
thinking public of the entire civilized world, is the grand 
victory which science, with the modern weapon intelli- 
gently wielded, has achieved against a disease which is 
foreign to this country and which, we sincerely hope, has 
been forever ostracised from our shores. 

A detailed account of the operaations of the United 
States Marine Hospital Service, ably guided by our local 
physicians, will be found in another part of this volume 
(Part IV). For the benefit of the layman and the busy 
practitioner, the following summary has been made by 
Mr. James M. Augustin, of the staff of the Neio Orleans 
Picayune : 



882 HISTORY OF YILLOW FEVER. 

AVlien it became known to the public on July 21st, 1905, 
that there was yellow feyer in Xew Orleans, an inyesti- 
gation by the health authorities brought out an estimate 
of one hundred cases and twenty deaths, up tO' that date. 
This supposition was borne out by the yital statistics for 
the month of July, in which the death-rate was abnor- 
mally large, the mortality from typhoid feyer haying 
been oyer twenty in excess of the normal ; and it was on 
this record that Dr. Kohnke, the Health Officer of the 
City, based his estimate of twenty deaths from yellow 
feyer, prior to July 21st. After that date, the number 
of cases and the death rate ran on eyen lines, possibly a 
little in excess of the same rates for the corresponding 
period of 1878, until the highest record was reached on 
August 12th, when 105 cases were reported, and many 
citizens belieyed that the disease was beyond control. 

The work of eradication was begtm by Dr. Kohnke in 
a small way, with such means as he had at his disposal, 
and when oji July 26th, Dr. J. H. White, of the United 
States Public Health and Marine Hospital Seryice offered 
him such assistance as he could render, the offer was 
accepted. Passed Assistant Surgeon Kichardson was 
detailed to help in the organization of the work in the 
infected quarter, bounded by St. Ann, Eampart, Barracks 
Streets and the Mississippi Eiyer; and a few days later 
on the arriyal of Passed Assistant Surgeon Berry, he also 
was assigned to the same duty. About this time it be- 
came eyident that the infection was widespread, not only 
in Xew Orleans, but in other part of Louisiana and Mis- 
sissippi; and the State and City Boards of Health, real- 
izing the tremendous task which confronted them, asked 
In conjunction with the business organizations, the aid 
of the National Goyernment by sending a telegram to the 
President. This met with the prompt acqtiiescence of the 
President, and after an exchange of telegrams between 
the Citizens' Committee and the Surgeon General to 
^'hom the matter had been referred, it was arranged that 
the United States Public Health and Marine Hospital 
Seryice proyide the number of officers estimated, by Dr. 



NEW ORLEANS 1905. 883 

White, to be necessary for the work, and that the City 
authorities and the citizens should meet the remainder 
ol the exj)ense. The work to be done under Dr. White's 
direction, with an absolutely free hand, no conditions 
whatever being imposed upon him. 

AVhile the task to be undertaken — the eradication of 
yellow fever after it had already had a start with 616 
cases and a large number of foci — was the most stupend- 
ous of its kind ever attempted, the oi3portunity given by 
the people of New Orleans, the facilities extended, and 
the absolute non-interference on the part of politicians, 
constituted, altogether, a most remarkable exhibition of 
public spiritedness and presented a magnificent oppor- 
tunity to do good work. Dr. White and his staff of forty 
surgeons took charge on the 8th of August, and formed 
an organization in each ward on the 9th. To the ward 
organizations, Dr. Wliite transferred, from day to day, 
detachments of men from the original central office, 
which had been working under the City Board of i Health 
as one unit for the whole Cit}^ This was done because 
Dr.. White believed that the work to be done was too vast 
to be satisfactorily accomplished from a central oflftce, 
and that it Avould be preferable to have a number of head- 
quarters corresponding to the ward sub-divisions by 
wards. In order to guard against breakdown, the sys- 
tem of transferring, gradualh^, from; the central office to 
the sub-stations, in each ward, was adopted, for the dis- 
infecting, screening and oiling gangs, and this confinupi 
with the addition of new material to the ward headquar- 
ters until the central force was entirely eliminated and 
the work finally rested in the hands of the ward com- 
manders. In addition, a force was maintained in the 
district originally inf'iected, doing daily house to house 
inspection and disinfection, sometimes of whole blocks, 
until about the middle of September when the originally 
infected district became justly known as the "disinfected 
district," and from a sanitary standpoint, one of the clean- 
est places in the City. 

As an illustration of the character of the work that 
was done, let it be supposed that a physician reports a 



884 HISTORY OF YELLOW FEVER. 

case of either yellow fever or of suspicious fever, to the 
central office or to the ward in which the case is located. 
The screening wagon immediately goes to the case. If 
the patient is not too ill to be removed, a room is screened 
and all the miosquitoes therein are killed by sulphur fumi- 
gation (two pounds of sulphur to one thousand cubic 
feet of air space). Then the screened room is properly 
ventilated to eliminate the last trace of the sulphur fumes 
and the sick person is moved into that room. The other 
rooms are similarly treated. If the patient is too ill to 
be remoA^ed from one room to the other, the preliminary 
fumigation is omitted; but as soon as possible without 
detriment to the sufferer, a thorough killing of mosqui- 
toes is undertaken. The ward commander keeps in con- 
stant touch with the attending physicians. If the houses 
on either side are very close to the infected premises, 
rhey, too, are fumigated. Preliminary to the final dis- 
infection, all cracks in doors and windows are sealed, as 
also the orifice of the fire-place. The workers are cau- 
tioned to make as little noise as possible, because the 
patient m^ust not be disturbed, and the mosquitoes must 
not be frightened so as to seek safety in flight. There- 
fore, all pasting is done first, then all furniture, or any 
article or ornament liable to damage from sulphur fumes 
are removed, and then the sulphur pots are lit, and the 
door immediately closed. 

If the occurrence of- a group of cases in close proximity 
to one another indicated the existence of a new focus of 
infection, the fumigation was applied to whole blocks 
and this method effectually arrested the spread of the 
disease. 

The State, the City and the citizens contributed more 
than 1310,000 to help in the work of stamping out yellow 
fever, and of that amount, at least four-fifths was sub- 
ject to Dr. White's order. The State's appropriation 
was 1100,000, the City's |60,000, and the citizens' con- 
tribution 1160,000. No outside aid was accepted, and 
several offers for assistance were declined with gratitude. 
Besides the above amounts, there was raised considerable 



NEW ORLEANS 1905. 885 

money by the volunteer ward organizations, who spent 
$30,000 for screening of cistern, and oiling them, and in 
inspections for sanitary purposes. The fight against in- 
fection was extended to every parish in Louisiana, 
\^'hereYer the fever appeared, and some of the expenses 
were borne by local appropriations. 

Ju]y 21st, an address was issued to the citizens of 
New Orleans, signed by Dr. Quitman Kohnke, health 
officer, and Dr. J. H. White, Surgeon U. S. P. H. & M. 
H. Service, and endorsed by the advisory committee of 
the Orleans Parish Medical Society, calling attention to 
the emergency existing in the city, and asking the help 
of every individual for the limiting and preventing of 
the spread of the disease. It having been scientifically 
proved that the mosquito is the only means of transmis- 
sion of yellow fever, it is especially urged that the fol- 
lowing simple directions be followed by the householders 
of the city, for the summer months : 

1st. Empty all unused receptacles of water. Allow 
no stagnant water on the premises. 

2nd. Screen cistern after placing a small quantity of 
insurance oil (a teacupful in each cistern), on the sur- 
face of the water. 

3rd. Place a small quantity of insurance oil in cess- 
pool or privy vault. 

4th. Sleep under mosquito nets. 

5th. Screen doors and windows whenever possible, 
with fine screen wire. 

July 26tli an emergency hospital on Dumaine Street 
was opened in charge of Dr. Hamilton P. Jones and a 
staff of yelloAv fever experts. It had a capacity to accom- 
modate eight}^ patients. 

Rev. Paroli, a Catholic priest of Italian nationality, 
and immune, was installed as chaplain, and also for the 
purpose of visiting the sick Italians and inducing them 
to consent to removal to more Itygienic surroundings. 
The chief men in the Italian colony aided greatly in this 
work of education among their countrymen, and also got 



886 H J STORY OF YELLOW FEVER. 

up a subscription which amounted to fiye thousand dol- 
lars to be used in relief work. 

Besides his work of stamping out the fever by practical 
means, Dr. White disseminated good advice. He sug- 
gested : First. That the ward organizations be made per- 
manent, and the work that is being done should continue. 

Secondly. That throughout the entire City there 
should be a ^'mosquito-killing day/' once a week. On 
that day, the entire population should make an effort to 
kill just as many mosquitoes as possible, by fumigating 
their houses with sulphur. 

Thirdly. That all gutters be thoroughly flushed once a 
week. 

Fourthly. That inspections of cisterns be made, in 
each ward, every week, to finel out if they have been prop- 
erly screened. 

Fifthly. That all suspicious cases be repcrted at once 
to the central offlce. 

Dr. White was solicitous in impressing the citizens with 
the absolute necessity of conforming to the rules and reg- 
ulations based on the new doctrine of transmission of yel- 
low fever by the mosquito, and with the assurance that the 
house quarantines of previous epidemics would not be 
resorted to. He also enlisted the co-operation of physi- 
cians by sending the following letter to every doctor in 
the city: "Considering the imperative necessity of insti- 
tuting, at the earliest possible moment, prophylactic meas- 
ures in the case of any person suffering of a fever which 
may, subsequently, be shown to be yellow fever, you are 
urgently requested to report to this office not only any case 
of fever which you may be sure is yellow fever, but also 
any case you may be unable, even at your first visit, to 
say is not yellow fever. We enclose you carets which will 
facilitate your report of such cases, and will, at the same 
time, give us your authorization to inspect the said prem- 
ises and do whatever may be necessary to prevent the ex- 
tension of the infection in the house or neighborhood. 
We desire simply to get the co-operation of the eutire 
profession of this city in the checking of the multipli- 



NEW ORLEANS 1905. 887 

cation of new foci of infection, and the early destructioin 
of those already existing." 

Dr. White made a persistent, systematic and scientific 
fight against yelloAv fever, and its agent of transmission — • 
the mosquito — and won. From August 12th until frost 
occurred on December 5, there was a constant and steady 
decline in the number of cases, daily. The greatest num- 
ber of cases was from August 12th to 16th, when for those 
five daj's the number was 338. The record for the last five 
days ending October 10th was 108. 

The official record of deaths for these periods in 1878 
and 1905 was : 





Aug. 16, 




Oct. 10, 


1878. 


1905. 


1878. 


1905. 


27 


4 


54 


4 


31 


4 


48 


1 


22 


6 


41 





14 


12 


48 


3 


20 


12 


39 


4 



114 38 230 12 

There had been no frost, and yet the figures were drop- 
ping, not as rapidly as could be wished, but with a grati- 
fying certainty, towards the vanishing point. And this, 
when the city of New Orleans had not quarantined against 
any infected point to any greater extent than to put on an 
observation of persons arriving from these points; and 
when many infected persons came here and were taken 
sick. It is highly probable that at least ten per cent, of 
cases were of people coming from infected localities. 

Dr. White commended the idea and helped the people 
in carrying it out, of cleaning gutters, screening and oil- 
ing cisterns, cleaning up back yards, emptying vaults, 
draining low lands, &c., not because this sanitary work 
would tend to eliminate yellow fever per se, but because 
it served the purpose of destroying the mosquito family. 
The fight made on the mosquito was productive of notable 
results. In spite of the general ignorance of the prin- 
ciples of the mosquito doctrine of yellow fever infection, 



888 HISTORY OF YELLOW FEVER. 

and the amount of prejudice against the acceptance of a 
new theory, modern thought prevailed, and while preju- 
dice paid its price in lives and suffering, that price was 
not nearly as great as would have been if the men of 
science had failed in their duty. 

The epidemic, it was generally conceded, had its origin 
in infection brought into New Orleans during the latter 
part of May, 1905. The epidemic of 1878, also began in 
May. That of 1878 pursued its death-dealing course, un- 
checked, until the frost came. The death roll aniounted 
to 4000 persons in the City of New Orleans alone. The 
visitation of 1905 had a larger non-immune population to 
feed upon, and double the number of inhabitants. It was 
discovered about the same time, in the middle of July, 
and side by side, the figures will show that if it had been 
allowed to co'utinue its course, the record of 1878 would 
have been surpassed. As a matter of fact that record was 
surpassed in the total number of deaths up to August 
10th. But that date was the turning point in the fight. 
The campaign started by Health Officer Kohnke, in July, 
and taken up by the Marine Hospital Service on August 
8th, and enlarged and extended so to better meet the con- 
ditions, began to tell and, thenceforth, the followers of the 
new doctrine knew they had won. The City of New 
Orleans and the whole South were fortunate in the selec- 
tion of the man who led them out of darkness, and showed 
them that yellow fever was no more the bugbear and terror 
of bygone days. 

It is confidently predicted that yellow fever will never 
again be able to commit such ravages in New Orleans. 
The acceptance of the modern doctrine is universal since 
the complete demonstration in this City, by the stamping 
out of the fever before frost, something never heard of 
before, when it had gained such a foothold as it had, in 
1905. The fight is now against the source of infection, 
which is Latin America. 

Eoio Was Yelloio Fever Introduced in Netv Orleans in 

1905? 

From the report of Dr. Souchon, President of the Louis- 
iana State Board of Health to Governor Blanchard, on 



NEW ORLEANS 1905. 889 

the 3rd of December, 1905, the following synopsis is had : 

'•"The first knowledge of cases suspicious of fever reached 
President Souchon on Wednesday, July 12th, at 3:45 P. 
M., when two physicians called at the office and informed 
him that they each had a case presenting symptoms sus- 
picious of yellow fever; one a woman Avho had died that 
day at 1039 Decatur Street, the other, a boy, son of a 
man who kept a grocery two doors from the home of the 
woman, and who lived at 2520 Bayou Koad Street. The 
boy was expected to die at any m/oment, and died about 
the time of the interview. The two physicians stated that 
these two cases lacked one of the most important symp- 
toms of 3^ellow fever: want of correlation between the 
pulse and temperature, and that they had not called to 
report these cases as yellow fever, but to mention them as 
suspicious and confer with the health authorities about 
them. 

On Thursday, July 13th, one of these same physicians 
told President Souchon that he thought he would have 
two more suspicious cases to report the next day. These 
cases were reported on the following day, at 1107 Decatur 
Street, suspicious of yellow fever, which he decided to 
see, himself, and he did so. Dr. Souchon-s opinion was 
that these cases presented some symptoms of yellow fever. 
These four cases, each presenting some suspicious symp- 
tom,s, had been reported direct to President Soucnon by 
two physicians, but not one of the attending physicians 
was vv^illing to shoulder the responsibility of pronouncing 
them, positively, yellow fever. 

On Monday, July 17th, a ph^^sician notified President 
Souchon that there were two cases of yellow fever in the 
Hotel Dieu, and the president went to the Hotel Dieu, 
and saw two cases presenting symptoms of yellow fever. 

The next day the State Board of Health, after hearing 
the report of Dr. Souchon, instructed him by resolution 
to write to Dr. Wymam, Dr. Tabor, of Texas ; Dr. Hunter, 
of Mississippi, and Dr. Sanders, of Alabama, that there 
were cases, here, presenting symptoms of yellow fever. 

After the arrival of health officers from other Southern 
States, an autopsy was held at the Charity Hospital, the 



890 HISTORY OF YELLOW FEVER. 

findings of which were indisi)utablT yellow fever. This 
was wired to Dr. Wyniam, and other health ofiicers by 
President Sonchon, and it was also made pnblic. 

In his report, Dr. Sonchon asks ''How yellow fever en- 
tered the State?" 

He replies, ^'This the Board frankly admits, it does not 
know.-' 'Several hypotheses can be adduced, however. 

It is probable that yellow fever existed in Belize and 
Puerto Cortez for several weeks before it was rex)orted 
here, and that a case from Belize or Cortez, in period of 
incubation, was introduced here before the Marine Hos- 
pital advised the Board, on May 24th, that yellow fever 
existed in those places. In the light of subsequent events 
it is now a well-established belief, that yellow fever had 
existed here for quite a while before it was brought to the 
surface. It is said that a case died in the Charity Hos- 
pital on May 31st, presenting symptoms of yellow fever, 
but the house surgeon said it was not yellow fever, ^^^d 
one physician who had a large Italian practice, told Pres- 
ident Souchon that the first two cases he knew presenting 
suspicious symptoms, were seen by him, accidentally, on 
July 1st, but that he had seen none before. Both died. 

Report of Dr. Q. KoJinJce, City Health Officer. 

The report of Dr. Kolmke agrees, in the main with that 
of Dr. Souchon as to the date of discovery of the first 
case of yellow fever, and it goes on to give details of the 
preventive and precautionary measures taken ; and speaks 
of the assistance given by the citizens, and the aid 
promptly rendered by the Italian Citizens' Committee; 
also the systematic fumigation, disinfection and other 
hygienic measures prosecuted. Dr. Kohnke speaks in 
high terms of the excellent work done by Dr. J. H. White, 
of "the U. S. Public Health and Marine Hospital Service. 
He says: 

^The splendid work of the corps headed by Dr. White 
cannot be too highly valued ; the results obtained should 
not, however, be attributed to this cause alone; for, the 
volunteer ward organizations and the combined influ- 



NEW ORLEAN& l905. 891 

ences, organized and individual, of men and women, dis- 
tinguished visitors and residents, all contributed impor- 
tantly, to the successful issue of the first extensive cam- 
paign against yellow fever in a large American city." 

AYith reference to the preventive measures by the cam- 
paign against the mosquito, Dr. Kolinke says : 

^'A comparison of the present visitation with that of 
1878, and consideration of the fact that the infection, 
appearing on a given date, is modified by the preventive 
measures api^lied about fifteen days previously, shows the 
continuous effect of mosquito; destruction instituted with 
our first knowledge of the possible presence of infection. 
The period of fifteen days after AugustlO th, in 1878, was 
marked by an increase in number of cases reported daily 
to an average of 104 cases, while in 1905, the dail}^ aver- 
age for the same jieriod, was sixty-one cases. The deaths 
(daily average), were, in 1878, thirty- two, while in 1905, 
the daily average was seven. In 1878 the fever increased 
markedly, toward September. In 1905 it decreased. The 
highest point reached was on September 12, when more 
than one hundred cases were reported. 

After that date the cases dwindled down and ere many 
days the victory was won. 

Report of Dr. Thomas^ Quarantine Physician. 

Under date of October 30th, 1905, Governor Blanchard 
made a request on Dr. John N. Thomas, State Quarantine 
Physician at the Mississippi Quarantine Station for a full 
and complete report of his administration of the Quaran- 
tine Station, insofar as the same is, or is not, responsible 
^or the introduction of yellow fever into New Orleans. 

The Governor presented five subjects to guide Dr. 
Thomas in the preparation of the report, viz. : 

1st. Description of official duties. 

2nd. Powers and duties of the State Board of Health 
in connection with the Quarantine Station. 

3rd. Quarantine regulations, and by whom prescribed ; 
also, detailed methods of eni^orcement, and names of sub- 
ordinates. 



892 HISTORY OF YELLOW FKVIR. 

4th. Details of the arrivals of ships with fever, aboard ; 
what was done about them; what bills of health they 
carried; and, if fmnjigated at port of departure. 

5th. Were there any modifications of quarantine 
regulations? 

The substance of Dr. Thomas' report was that the laws 
and regulations were fully enforced ; that he did not know 
how the fever got into New Orleans, but, if the infection 
came through infected mosquitoes, it came from Colon or 
from Havana; if through an infected individual, from 
Havana, most likely, or possibly from one of the ports 
vv'ithin the five days' limit. He believed the period of 
detention should not be less than six days. He presented 
a great deal of evidence to show that Havana was infected, 
and he considered the Island of Cuba a constant menace. 

Dr. Thomas submitted the following list of vessels which 
arrived at Quarantine with fever on board: 

July 8. Saphir, from Colon, 1. 

July 9. Royal Exclianqe, from Colon, via Mobile, 1. 

Jul}^ 31. Texan, from Vera Cruz, 1. 

August 8. Porto Rico, from Vera Cruz, 1. 

August 12. SapJiir, from Colon, 3. 

August 24. Orifien, from Colon, 4. 

September 8. Excelsior, ftom Havana, 1. 

October 27. City of Tampico, from Vera Cruz, 1. 

October 27. 8t. Croix, from Vera Cruz, 1. 

Total cases imported, 14. 

All of these vessels, except the Excelsior, and the Porto 
Rico, had been fumigated at the port of departure, and 
the disease broke out, on all of them, within five days after 
fumigation. 

Dr. Thomas said ^^I believe that yellow fever is usually, 
if not always imported through an infected individual, 
with the disease incubating in his system, who passes 
through one of the many quarantine stations, and gets 
into the country before the initial attack of fever. Since 
it is known, however, beyond doubt, that the mosquito 
is the conveyor of the disease, I believe that, under favor- 
able conditions, nnosquitoes can be imported from infected 
ports, and be the means of conveying and spreading the 



LOUISIANA. 893 

disease in the country. If this were not a possibility, 
what is the use of fumigating vessels, for we fumigate now, 
to kill mosquitoes only? 

"We wej?e infected this year thruogh one of these 
sources ; I am unable to say which, for I do not know. If 
however, it was through imported infected mosquitoes, I 
would say that we got our infection from Colon, or from 
Havana. If through an infected individual, from Havana, 
most likely — pjo^sibly from a port within the five days' 
limit, and the case developed after five days." 

^^EWTON. 

1905. One case; recovery. 

OLIVIA. 
1905. Cases, 6; deaths, 1. 

OMEGA AND KALEIGH LANDINGS. 
1878. Deaths, 5. 

OPELOUSAS. 

1826. Infected by New Orleans. Cases, 3; deaths, 1. 

1828. Infected by New Orleans. Cases, 4; deaths, 3. 

1829. No record of cases and deaths. 

1837. First case, October 20; last case in November. 
1839. First case in August; last case in November. 
1842; 1853; 1867. No record of cases and deaths. 

OSTEICA. 

i 

1905. First case, July 26. Cases, 1; deaths, 0. 



894. HISTORY OF YKLLOW FEVER. 

PAINCOUKTVILLE. 

1878. Population, 400. First case, August 14; last 
case, October 26. Cases, 181; deaths, 15. 

PATTEESON. 

1853. Infected by New Orleans. First case, August 
13; last case in December. No statistics. 

1854 ; 1855 ; 1857. First case, September. No statistics. 

1863. First case, August 8; first death, August 13; 
last case and last death in December. Cases, 500 ; deaths, 
45. 

1878. The first case, Mrs. Dr. L. W. Tarleton, con- 
tracted the disease at Logonda Plantation, where the 
disease is supposed to have been brought from New 
Orleans, September 2. She died soon after. The disease 
spread rapidly and was very malignant. Cases, 125; 
deaths, 28, of which 5 were colored. Cases near town, 
white and colored. 175; deaths outside town, whites, 40; 
colored, 25. Date of last death, Noyember 23. 

1879. First case, November 26 ; last case, December 6. 
Cases, 2; deaths, 0. 

PHAEE PLANTATION. 

1879. Infected by Berwick. First case, November 10 ; 
last case, December 2. Cases, 6; deaths, 5. 

PILOT TOWN. 

1878. Infected by Port Eads. First case, August 18 ; 
last case, October 16 ; first death, August 22. Cases, 113 ; 
deaths, 17. 

PATTEESON. 

1897. Cases, 1 ; no deaths. 

1905. First case, July 31. Cases, 700; deaths, 52. 

PECAN GEOVE. 

1878. Deaths, 2. 

1905. First case, August 18. Cases, 20; deaths, 5. 



LOUISIANA. 895 

PLAQUEMINE. 

1837 ; 1839 ; 1817. ^'o record of cases and deaths. 

1853. First case, August 20; first death, August 26; 
last case, December 15; last death, December 9. 

1858. No record of cases and deaths. 

1878. Population, 1,500. Infected by Xew Orleans. 
First case, August 1. Cases, 1,159 ; deaths, 125. 

1898. First case, October 15; last case, October 15. 
Cases, 6; deaths, 1. 

POIXTE MICHEL. 

1880. SiDoradic cases. 

POIXT PLEASANT. 

1878. Fever appeared in August. There were about 
60 cases and 13 deaths. 

PLATTEXYILLE. 
1905. Cases, 1; deaths, 0. 

POINTE-A-LA-HACHE. 

1851. First case, October. . 

1878. Cases, 4; deaths, 4. 

1905. First case, October 2. Cases, 1; deaths, 0. 

POINT CELESTE. 
1905. First case, July 30. Cases, 32; deaths, 6. 

PONCHATOULA. 

1878. Infected by New Orleans. First case, October 
6 ; first death, October 10. Cases, 12 ; deaths, 3. 

POET BARRE. 

1870. No record of cases and deaths. 



896 HISTORY OF YELLOW rCTKE* 

POET BAKROW. 

1878. Deaths, 7. 

1905. First case, July 24. Cases, 73, deaths, 10. 

PORT EADS. 

1878. August 5, one case of yellow fever appeared, and 
August 11, fourteen cases. Dr. Warren Stone, with two 
nurses, Mrs. Dupree and Mrs. Eastman, came from New 
Orleans to attend them. He telegraphed back, '^fever in- 
creasing." The first fatal case was Mrs. Capt. Moran. 
The cases occurred rapidly. Many workmen went away, 
and work on the jetties was suspended. Total cases, 62; 
total deaths, 14. Date of last death, October 11. 

PORT HUDSON. 

1839. Infected by New Orleans. 
1841. No record of cases and deaths. 
1843. No record of cases and deaths. 

1878. First case, September 9; first death, September 
13. Cases, 100; deaths, 11. 

PUGH PLACE. 

1879. First case, October 2. Cases, 33 ; deaths, 0. 

PROSPECT PLANTATION. 

1905. Cases, 8; deaths, 1. 

RALEIGH LANDING. 

1878. No record of cases and deaths. 
1905. One case, August 6. 

REBECCA PLANTATION. 

1905. First case, September 10. Cases, 20 ; deaths, 1. 



LOUISIANA. 897 

BED KIVEK LANDING. 

1878. No record of cases and deaths. 

EESERVE PLANTATION. 
1905. First case, August 14. Cases, 14; deaths, 2. 

EICHOC. 

1878. Cases, 62; deaths, 18. 

EIVERSIDE PLANTATION. 

1905. First case, July 23. Cases, 218 ; deaths, 10. 

ROSEDALE. 
1905. First case, September 5. Cases, 5; deaths, 1. 

SARPY. 
1905. First case, August 19. Cases, 13; deaths, 2. 

SHELBURN. 
1905. Cases, 15; deaths, L 

SHREVEPORT. 

1853. No record of cases and deaths. 

1873. Population, 9,000. Infected by New Orleans. 
First case, August 12; first death, August 19; last case, 
November 10. Cases, 3,000; deaths, 759. 

1905. Cases, 3; deaths, 1. 

SHREWSBURY. 
1905. First case, August 15. Cases, 6; deaths, 2. 

SMITHLAND. 

1878. A plantation in Point Coupee Parish, La. The 
only fatal case reported is that of Dr. W. D. Smith, who 
died September 25. 



898 HISTORY OF YELLOW FEVER. 

SMITHVILLE. 

1905. First case, September 6. Cases, 1; deaths/ 0. 

SMOKE BEXD. 

1905. First case, August 28. Cases, 3; deallis, 1. 

SOUTHDOWN. 
1905. First case, October 19. Cases. 1; deaths, 1. 

SOUTH PASS. 

1878. Cases, 42; deaths, 2. 

SOUTHWEST PASS. 

1878. Cases, 26 ; deaths, 8. 

STEYEXSOX. 

1878. Two fatal cases. 

ST. BERXAED. 

1878. Infected by Xew Orleans. First case, August 
25 ; first death, August 29. Cases, 19 ; deaths, 7. 
1905. First case, July 20. Cases, 54; deaths, 2. 

ST. CLAEE. 
1905. Cases, 1 ; deaths, 0. 

ST. ELIZABETH. 
1905. First case, July 13. Cases, 21 ; deaths, 8. 



LOUISIANA. 899 

ST. FKANCISVILLE. 

1811 ; 1817 ; 1819 ; 1823 ; 1827 ; 1828. No record of cases 
and deaths. 

1829. First case, September 22. 

1839. First case, August 28. 

1843. First case, August 28. 

1846. Deaths, 1. 

1848. Deaths, 1. 

1853. No record of cases and deaths. 

ST. GABEIEL. 

1878. Population, 425. Cases, 132; deaths, 38. 
1905. Cases, 2; deaths, 0. 

ST. JAMES. 

1878. Cases, 36; deaths, 4. 

1898. First case, October 1; last case, October 1. 
Cases, 1 ; deaths, 0. 

ST. JOSEPH. 

1905. First case, September 18. Cases, 3; deaths, 0. 

ST MARTINVILLE. 

1839. No record of cases and deaths. 

ST. EOSE. 

1905. First case, August 22. Cases, 61; deaths, 6. 

STORY'S. 

1905. Cases, 2; deaths, 0. 

SUNRISE. 
1905. First case, July 30. Cases, 1; deaths, 0. 



900 HISTORY OF YELLOW FEYER. 

TALLULAH. 

1878. Cases, 33 ; deaths, 4. 

1905. First case, about August 8. Cases, 1,040; 
deaths, 23. 

TANGIPAHOA. 

1878. Population, 200. Infected by New Orleans. 
First case, September 1. Cases, 150; deaths, 50. 

TECHE COUNTEY. 

1878. Population, 1,033. First case, September 10; 
first death, September 13. Cases, 715; deaths, 81. 

TEKEE-AUX-BOEUF. 

1905. First case, September 9. Cases, 1; deaths, 0. 
THIBODAUX. 

1839. Sporadic cases. 

1846. First case, September 20 ; last case, October 15 ; 
last death, October 14. 

1853. Deaths, 100. 

1854. First case, September 12; last case, October. 

1878. Population, 2,800. First case, July 30; first 
death, August 28. Cases, 750 ; deaths, 65. 

1879. First case, October 15; last case, October 15. 
Cases, 1; deaths, 0. 

1905. Cases, 1; deaths, 1. 

TOCA. 

1905. First case, September 8. Cases, 10; deaths, 0. 

TEENTON. 

1853. Population, 145. Infected by New Orleans, 
First case, August 1; first death, August 6. Cases, 52; 
deaths, 28. 



LOUISIANA. 901 

UNION PLANTATION. 

1905. First case, October 13. Cases, 1; (ieatlis, 0. 

UPPER TEXAS. 

1879. First case, October 6; last case, October G. 
Cases, 2; deaths, 0. 

VACCARO. 

1905. First case, July 26. Cases, 2; deaths, 0. 

VACHERIE. 

1878. No record of cases and deaths. 

VAENER. 
1898. Cases, 1; deaths, 0. 

VERRET. 
1905. First case, September 4. Cases, 2; deaths, 0. 

VIDALIA. 

1853. Population, 60. Infected by Natchez, Miss. 
First case, August 20 ; first death, August 25. Deaths, 16. 

VILLE PLATTE. 

1870. No record of cases and deaths. 

VIVIAN. 

1879. Cases, 4 ; deaths, 0. 

WAGGAMAN. 

1905. First case, July 16. Cases, 60 ; deaths, 5. 



902 HISTORY OF YELLOW FEVER. 

WASHINGTOIs^ 

1837. No record of cases and deaths. 

1852. Infected by New Orleans. First case, Septem- 
ber 14 ; first deatlij September 16. 

1853. First ca-e, August 15. 

1854; 1867. No record of cases and deaths. 

WATEKLOO. 
1839. Infected by New Orleans. 

WATEEPROOF. 

1905. First case, September 23. Cases, 1; deatlis, 0. 

WEEK'S ISLAND. 
1879. No record of cases and deaths. 
WESTWEGO. 

1905. First case, July 25. Cases, 2 ; deaths, 2. 
WILSON. 

1898. First case, September 26; last case, October 15. 
Cases, 303 ; deaths, 7. 

WOODLAWN. 

1905. First case, July 30. Cases, 16; deaths, 2. 
Insert Bibliography 



NEW ORLEANS RIOGRAPHY. 903 

BIBLIOGRAPHY OF YELLOW FEVER IN LOUISIANA. 

NEW ORLEANS. 

Albers (F. B.) : Cases of Sporadic Yellow Fever (1857). N.. O. Med. 
& Surg. JL, November, 1857, p. 357. 

American Institute of Homoeopathy. Special report of the Homeoo- 
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presentation to Congress. 8°. New Orleans, 1879. 

Analysis of the records of yellow fever in New Orleans in 1876,. N. 
O. Med. and Surg. Journal, 1876-7, n. s. vol. 4, p. 480. 

Axson (A. F.): Report on the Origin and Spread of the Epidemic in 
New Orleans in 1853. In Report of the Sanitary Commission of New 
Orleans, 1854. 

Bahier (A.) (et al.) : Rapport fait a la Societe Medicale de la 
Nouvelle-Orleans sur I'epidemic de fievre jaune qui a regne dans cette 
ville pendant I'ete et I'automne de I'annee 1839.. 8°. Paris, 1840. 

Barbot (J. P.): Cases of Yellow Fever (1857). N. O. Med. and 
Surg. Journal, November, 1857, p. 358. 

Barton (Ed. E.): Account of the epidemic fever which prevailed in 
New Orleans during the autumn of 1833. American Journal of Med. 
Sciences, vol. 15, p. 30. 

Barnes (F.) : Yellow fever in New Orleans. New Orleans Med. and 
Surg. JL, 1867, vol. 20, p. 196. 

Barton (Ed. E.) : Report read to the Academy of Sciences of New 
Orleans in defence and explanation of the report of the Sanitary 
Commission to the City Council. N. O. Medical News and Hospital 
Gazette, vol. 2, No. 3, p.. 97. 

Barton (Ed. E.) : Report of the Board of Health of New Orleans, 
November 17, 1841, on the fever of that year.. Bulletin of Medical 
Sciences, vol. 2, p. 1. 

Barton (Ed. E.) : Report upon the Sanitary Condition of New Or- 
leans, in report of the Sanitary Commission of New Orleans for 1853, 
p. 213. 

(See review of the ahove Report, in N. O. Med. and Surg. Journal, 
vol. 11, p. 523; do., in Charleston Medical Journal and Review, vol. 10. 
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Barton (E. E.) : Account of the Epidemic Fever which prevailed in 
New Orleans during the autumn of 1833. American Journal of Medical 
Sciences, vol. 15, p. 30. Same in pamphlet form, with additions, pp. 
52, Philadelphia, 1834. 

Barton (Ed. E.) : Report to the State Medical Society on the 
Meteorology, Vital Statistics, and Hygiene of the State of Louisiana. 
Bvo. New Orleans, 1851. 



904 HISTORY OF YELLOW FEVER. 

Barton (.E. H.) : The cause and prevention of yellow fever at New 
Orleans and other cities in America; and notices of tlie repjort of tlie 
Sanitary Commission, dated New Orleans, December 12, 1854. 3 ed. 
8=. New York, 1857. 

Barton (E. H.) : Report on the Meteorology, Mortality and Sanitary 
Condition of New Orleans, for the years 1854 and 1855. Trans. Amer. 
Med. Assn., 1856, vol. 9, p. 723. 

Barton (Ed. E.) : Introductory Lecture on Acclimation. Svo. New 
Orleans, 1857. 

Baxter: Statement of the Yellow Fever as it Occurred in Xew Or- 
leans in 1819. New York Medical Repository, vol. 21, p. 1. 

Baxter (J.) : Reply to the Replication of the Medical Society of 
Louisiana. Med. Repository, 1822, n. s., vol. S, pp. 223; 229. 

Berjot (E.) : Report of the epidemic of yellow fever, which raged at 
New Orleans in 1878. N. O. Med. and Surg. Jl., 1880, n. s., vol. 8, pp. 
139; 145. 

Board of Health and Yellow Fever. New Orleans Med. Jl., 1844-5, 
vol. l, pp. 217; 219. 

Barren (P. D.) : An Historic Memorabile (relating to the yellow 
fever epidemic of 1799). New Orleans Medical and Surgical Journal, 
1896-7, vol. 49, p. 318. 

Bemiss (S. M.) : Report upon yellow fever in Louisiana 1S7S, and 
subsequently. N. O, M. & S. Jl., 18S3-S4, n. s., vol. 11, pp. 81, 161. 4 
diag. 2 ch. Also: Reprint. 

Beugnot (J. P.) : An Essay on Yellow Fever. N. 0. M. & S. JL, vol. 
1, p. 1. 

Beyer (G. E.) : On the origin of sporadic cases of fever. N. 0. M. 
& S. Jl., 1906-7, vol. 54, p. 407. 

Boyce (R.) : Yellow Fever Prophylaxis in New Orleans, 1905. Liver- 
pool School of Tropical Medicine, Memoir XIX, 1906, p. 1. 

Bradj', (C. M.) : Circumstances of the First Appearance of Yellow 
Fever in New Orleans. N. 0. M. & S. Jl , 1905, vol. 58, p. 743. 

Bruns, fH. D.) : Experiences during the Yellow Fever Epidemic of 
1905. N. O. M. & S. JL, 1906, vol. 59, p. 196. 

Cartier (A. J. F.) : La fievre jaune de la Nouvelle-Orleans. 8°. 
Paris, 1859. 

Carroll (J.) : Yellow Fever in New Orleans. N. 0. M. & S. JL, 1906, 
vol. 59, p. 180. 

Castellanos (J. J.) : An Historic Memorabile. Proc. Orleans Parish 
Medical Society, 1S96, New Orleans, 1898, p. 168. 

Cartwright (S. A.) : Prevention of Yellow Fever. N. 0. M. & S. JL, 
1853-4, vol. 10, pp. 292, 406. Also: Ohio M. & S. JL, Columbus, 1S53-4, 
vol. 6, pp. 201, 227. 



NEW ORLEANS — RIBLIOGRAPHi . 905 

Chaille (S. E.) : Yellow Fever of 1858 in New Orleans. N. O. M. & 

5. Jl., 1858, vol. 15, pp. 805, 819. 

Chaille (S. E.) : The yellow fever, sanitary conditions, and vital 
statistics of New Orleans during its military occupation, the four 
years 1862-5. N. O, M. & S. Jl., 1870, vol. 23, pp. 536, 598. Also: 
Reprint. 

Chaille (S. E.): Yellow fever, or "yellow jaundice" in New Orleans 
in 1882; disputed case of Louis (or Ludwig) Deschler. N. O. M. & S. 
Jl., 1882, n. s., vol. 10, pp. 194, 205. 

Chaille (S. E.) : Some Yellow Fever Data. N. O. M. & S. Jl., 1905, 
vol. 58, p. 191. 

Coleman (W. L.) : Yellow Fever. N. O. M. & S. Jl., 1879, n. s., vol. 

6, p. 618. 

Considerations generals sur les mesures a prendre pour mettre la 
Nouvelle-Orleans a I'abri de la fievre jaune, 8°. Nouvelle-Orleans, 
1864. 

Conkrite (L.) : An inquiry into the pathology and 'treatment of 
yellow fever, as it prevailed at New Orleans, August, 1829. West. J. 
M. & Phys. Sc, Cincin., 1830, vol. 3, pp. 367, 393. 

Davidson (J. P ) : Some personal reminiscences of early epidemics 
in New Orleans. New Orleans Med. & Surg, JL, 1886-7, n. s. vol. 14, 
p. 920. 

Detention (The) Camp at Oakland Park. Rep. Bd. Health La., 
1896-7, Baton Rouge, 1898 ,p. 44, 3pl. 

Delery (C): (Rapport du Bureau de sante de la Nouvelle-Orleans 
pour I'annee 1860.) Jo Soc. Med. de la N,-Orleans, 1860-61, vol. 11, 
pp. 181, 185. 

Delery (C. F.) : Memoire sur I'epidemie de fievre jaune qui a regne 
a la Nouvelle-Orleans et dans les campagnes pendant I'annee ,1867. 
4°. Nouvelle-Orleans, 1867. 

Del Orto (J.): Yellow fever. N. O. M. «& S. JL, 1879, n. s., vol. 6, 
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Diary (The) of a Samaritan. By a member of the Howard Associa- 
tion of New Orleans. 8°. New York, 1860. 

Dowler (B.) : Tableau of the yellow fever of 1853, with tp.pographical, 
chronological, and historical sketches of the epidemics of New Orleans 
since their origin in 1796, illustrative of the quarantine question. 8°. 
New Orleans, 1854. 

Dowler (B.) : The first death from yellow fever in New Orleans, in 
1854. N,. O. M. & S. Jl., 1854-5, vol. 11, p. 284. 

Dowell. "Weekly summary cases and deaths in 1873. In his Yellow 
Fever and Malarial Diseases, 1876, p. 31. 

Dowler (B.) : Researches, Historical, Topographical and Critical, on 
Yellow Fever. N. O. M. & S.. Jl., 1846-7, vol. 3, p. 165. 



906 HISTORY OF YELLOW FEVER. 

Drew (E. S.): The first case of yellow fever in New Orleans, 1878. 
Santarian, N. Y., 1880, vol. 8, pp. 35, 37. 

Dupuy: Precis historique de I'epidemie de fievre jaune qui a regne 
en 1819 a la Nouvelle-Orleans. J. Gen. de Med., Chir. Pharm., Paris, 
1821, vol. Ixxiv, pp. 203, 229. Also Transl. (Abstr.) : Med. Reposit., N. 
Y., 1821, n. s., vol,. 6, pp. 15; 19. 

Editorial: Yellow Fever Situation (1905). N. O. M. «& S. Jl., 1905, 
vol. 58, p. 254. 

Epidemic (The) of 1853, at New Orleans. Golveston M. JL, 1867, 
vol. 2, pp.. 876, 907. 

Epidemic (The) summer. List of interments in all the cemeteries 
of New Orleans from May 1st to November 1st, 1853... To which is 
added a review of the yellow fever, its causes, (etc.) 8°. New Or- 
leans, 1853. 

Escumhas (M.) : La fievre jaune observee a la Nouvelle-Orleans 
pendant les mcis de Juillet, Aout, Septembre, Octobre, 1878, et son 
Traitement. 16°. Nouvelle-Orleans, 1879. 

Extraits de quelques-unes des lettres sur la fievre jaune. I, 2, 4, 7, 
lettres et appendise. 8°, Nouvelle-Orleans, 1859. 

Faget (J. C, ) : Etude medicale de quelques questions importantes 
pour la Louisiana, et expose succinct d'une endemie paludeenne de 
forme catarrhale, qui a sevi a la Nouvelle-Orleans, Particulierement 
sur les enfants, pendant I'epidemie de iflevre jaune de 1858. 8°. 
Nouvelle-Orleans, 1859. 

Faget (J. C): Considerations generales sur les mesures a prendre, 
sanitaries et quarantenaires, pour mettrw le Nouvelle-Orleans a I'abri 
de la fievre jaune. Union Med., Paris, 1864, 2. s., vol. 24, pp. 196, 334. 

First (The) death from yellow fever in 1858. N., O. M. & S. Jl., 1858, 
vol. 15, pp.. 568, 573. 

Fenner: The epidemic of 1847. N. O. M. & S. Jl., vol. 5, 1848-9, p. 
192. 

Fenner (E. D.) : An account of the Yellow Fever which prevailed in 
New Orleans in the year 1846. N. O. M. & S. Jl., vol. 3, 1846-7, p. 445. 

Fenner: An Account of the Yellow Fever in New Orleans in 1848. 
N. O. M. & S. JL, vol. 6, 1849-50, p. 9. 

Fenner: History of the Epidemic Yellow fever at New Orleans in 
1853. 8 vo. New York, 1854. 

Fenner: Fever Statistics; showing the relative proportion of the 
different forms of fever admitted into the New Orleans Charity 
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vol. 5. 

Grcs et Girardin: Rapport fait a la Societe Medicale (de la Nouvelle- 
Orleans), sur la fievre jaune qui a regne d'une maniere epidemique 
pendant I'ete de 1817. 8vo. New Orleans, 1817. 



NEW ORLEANS— BIBLIOGRAPHY. 907 

Halpheii (Michel) : Memoire sur le Cholera Morbus complique d'une 
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in the summer and fall cf 1833. Am. J. M. Sc, Phila., 1834, vol. 14, 
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H^ealth of the City. N. O. M. & S. JL, 1849-50, vol, 6, pp. 407, 410. 

Herrick (S. S.) : Review of the Yellow Fever in New Orleans, 
1869-74. Ibid., 1874-5, n. s., vol. 2, pp. 645, 652,. 

History of the yellow fever epidemic in the Fourth District; disin- 
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measures generally considered. Rep. Bd. Health Louisiana, 1878. 
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Holt (J.) : Analysis of the record of yellow fever in New Orleans in 
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90S HISTORY OF YELLOW FEVER. 

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NEW ORLEANS — BIBLIOGRAPHY. 909 

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910 HISTORY OF YELLOW FEVER. 

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Souchon (E.): The lessons cf the yellow fever in New Orileans in 
1879; forty-one cases and nineteen deaths; crude scientific sanitation 
and no quarantine. N. O. M. & S. JL, 1899-1800, vol. 52, p.. 133. 

Sternberg (G. M.) : Is yellow fever endemic in New Orleans? Am. 
M. Times, N. Y., 1864, vol. 8, p. 197. 

Taillefer (J. G. ) : Precis Analytique des Travaux de la Societe 
Medicale de la Nouvelle-Orleans. 1817 to 1818. New Orleans, 1819. 

Theard (S. L.) : New Orleans Yellow Fever in 1905. N. O. M. & 
S. JL, 1906, vol. 59, p. 361. 

Theard (S. L.) : An imported case of yellow fever; death. N. O. 
M. & S. JL, 1897-8, vol. 50, p. 279. Also: Proceedings Orleans Parish 
Medical Society, 1897. New Orleans, 1898, p. 180. 

Thomas: Traite pratique de la Fievre Jaune observee a la Nouvelle- 
Orleans. 8vo. Paris, 1848. 

Thomas: Rapport fait a la Societe Medicale sur I'epidemie de fievre 
jaune qui a regne a la Nlle.-Orleans pendant I'ete et I'automne de 
1837. J. Soc. Med. de la N.-Orleans, 1839, vol. 1, pp. 57, 63. 

Thomas: Relation de I'ep.idemie de fievre jaune qui a regne pendanr 
I'ete et I'automne de 1841 a la Nouvelle-Orleans. Bull. Acad, de Med., 
Paris, 1841-2, vol. 7, pp. 1016, 1037. 

Townsend (P. S.) : Account of the introduction of yellow fever into 
Pensacola and New Orleans in the year 1822. N. Y. M. & Phys. J., 
1823, vol. 2, p. 315, 320. 



NEW ORLEANS BIBLIOGRAPHY. 911 

Veazie (H, A.): Estivo-Autumnal Fever in New Orleans. 1896. 

Wa'tson (F. H.) : Yellow Fever in New Orleans. John Hopkins 
University Bulletin, 1906, vol. 17, p. 61. 

White (C. B.) : Disinfection in yellow fever, as practised in New 
Orleans in the year 1870 to 1876, inclusive; evidence of effectual 
sanitary resources against the specific causes of the fever. Am. Pub. 
Health Assn. Rep., 1875-6, N. Y., 1877, vol. 3, pp.. 154, 161. Also, 
Reprint. 

White (J. H.) : Service Operations in Connection with the Epidemic 
of Yellow Fever in New Orleans. Report Supervising Surgeon 
G-eneral, U. S., 1906, p. 143. 

Wyman (W.) : Yellow Fever in New Orleans. Public Health Rep. 
U.. S., Marine Hospital Service, Washington, 1905, vol. 20, p. 1557. 

Yellow fever in New Orleans. N. O. M. News & Hosp. Gaz., 1860, 
vol. 6, p. 766. 

Yellow Fever in New Orleans. N. O. Journal of Medicine, 1868, vol. 
21, p. 194. 

Yellow Fever in New Orleans, in 1853. N. York M. Gaz. & J. Health, 
1854, vol. 5, pp. 158, 165. 

Yellow (The) Fever of New Orleans in 1855. N. O. M. & S. Jl., 
1855-6, vol. 12, pp. 285, 288. 

Yellow Fever in New Orleans in 1882. (Edit.) N. O,. M. & S. JL, 
1882, n. s., vol. 10, pp. 146, 147. 

"Yellow fever and results of disinfection in New Orleans." Rich- 
mond and Louisville M. J., Louisville, 1874, vol. 17, pp. 224, 251. 

Yellow Fever. N, O. M. & S. JL, 1852-3, vol. 9, pp. 418, 421. 

Yellow Fever. N. O. M. & S. JL, 1873-4, n. s., vol. 1, pp. 306, 308. 

Yellow Fever (in city of New Orleans), 1871. Rep. Bd. Health La.., 
1871, N. O., 1872, pp. 11, 26. 

Yellow (The) fever epidemic at New Orleans in 1878; submitted by 
the New Orleans Auxiliary Sanitary Association, Dr. C. B. White, 
sanitary director. Am. Pub. Health A sn.. Rep. 1881, Boston, 1883, 
vol,. 7, p.p. 201, 204. 

Yellow Fever at New Orleans. Boston M. & S. JL, 1853-4, vol. 49, 
p. 165. 

Yellow Fever in New Orleans in 1882. (Edit.) N. O. M. & S. JL, 
1882, n. s,, vol. 10, pp. 227, 233. 

Yellow Fever and the Fruit Trade. Editorial in New Orleans 
Picayune, December 10, 1905. 

Yellow Fever in New Orleans during the year 1879. N. O. M. & S. 
J., 1879-80, n. s., vol. 7, p. 615. 

Yellow Fever; first cases in 1857. N.. O. M. & S. JL, November, 
1857, p. 357. 



912 HISTORY OF YELLOW FEVFR. 

SHREVEPORT. 

Jones (J.) : Yellow Fever in Shreveport. Boston M. & S. J., 1874, 
vol xc, pp. 73, 151. 

Dowell (G.) : Epidemic of 1873 (Shreveport). In his "Yellow Fever 
and Malarial Diseases," 1876, p. 39,. 

Report of the committee [of the Shreveport Medical Society] on 
the yellow fever epidemic of 1873, at Shreveport, Louisiana. 8°. 
Shreveport, 1874. 

Smith (H.): Report of the yellow fever epidemic of 1873, Shreveport, 
La. 8°. New Orleans, 1874. 

Spinzig (C.) : In his "Yellow Fever; Nature and Epidemic Character," 
St. Louis, 1880, pp. 19, 24, 46, 64, 65, 67, 97, 98, 99, 103. 

Yellow Fever Epidemic in Shreveport (1873). London Med. Times 
& Gaz., 1873, p.. 9. 

Ibid., 1874, p. 13. 

GENERAL. 

Bemiss (S. M.) & Mitchell (R. W.) : The fever on the Lower Missis- 
ippi. Nat. Bd. Health Bull., Wash., 1880-81, vol. 2, pp.. 553-557. 

Carroll (J.) : Lessons to be learned from the present outbreak of 
yellow fever in Louisiana. Jl. Am. M. Assn., Chicago, 1905, vol. 45, 
p. 1079. 

Chaille (S. E.) : Our yellow fever, sugar and cotton crops. N. O. 
M. & S,. Jl., 1881-2, n. s., vol. 9, p. 683. 

Circular of the Legislative Committee of the La. State Med. Assn. 
and of the Board of Health to Physicians throughout the State. N. 
O., 1878. 22p. 8°. 

Colvis: Fievre jaune a la Louisiane; doctrines de I'epidemicite et 
de I'importation. Gaz. Hebd. de Med., Paris, 1863, vol. 10, p. 635. 

Cooke (T. A.) : Practical Remarks on the Epidemic of Yellow Fever 
which prevailed at Opelousas, in the years 1837, 1839 and 1842. N. 0. 
M. & S. Jl., vol. 3, p. 27. 

Cooke (T. A.) : An Account of the Yellow Fever which prevailed in 
the town of Washington (La.) in 1853. N. O. M. & S. JL, vol. 10, p. 602. 

Cooke (T. A.) : Pratical remarks on the epidemic of yellow fever 
which prevailed at Opelousas in the years 1837, 1839, 1842. N. 0. M. 
& S. Jl., 1846-7, vol. 3, p. 27. 

Delery (C.) : Yellow fever in St. John the Baptist, La. N. O. M. & 
S. JL, 1853-4, vol. 10, p. 405. 

Dungan (J. B.): Yellow Fever at Jeannerette, La., in 1854. Trans. 
Amer. Med. Assn., 1856, vol. 9, p. 697. 

Fassitt (C. R.): Yellow Fever in the Country. An Account of the 
Disease as it Prevailed at Judge Baker's Plantation, Parish of St. 
Mary, La., in 1854. Trans. Amer. Med. Assn., 1856, vol. 9, p. 663. 



LOUISIANA BIBLIOGRAPHY. 9 I 3 

Fassito (C. R.) : Yellow fever in the country; an account of the 
disease as it prevailed, at Judge Baker's plantation, Parish of St. Mary, 
La., in September and October, 1854. N. O. M. News & Hosp. Gaz., 
1855-6, vol. 2, p. 406. 

Fenner (E. D.) : Report on the Epidemics of Louisiana, Mississippi, 
Arkansas and Texas, in the year 1853. Tranastions Amer. Med Assn., 
vol. 7, page 421. 

Fever Prevailing in Parish of Plaquemines, September, 1880. Re- 
ports by J. Dickson Bruns, J. P, Davidson and Geo. M. Sternberg. 8°. 
(New Orleans, 1878.) 

Fievre (La) Jaune en Louisiane (1878). L'Union Medicale, Paris, 
1878, vol. 26, pp. 275, 398. 

Fox (D. R.): Yellow Fever in the Country: An Account of the 
Disease as it Prevailed on the Coast below New Orleans, in 1854 and 
1855. Trans. Amer. Med. Assn., 1856, vol. 9, p. 665.. 

Gilpin (J.): An Account of the Yellow Fever that Prevailed in 
Covington, Louisiana, in 1847. N. O. M. & S. Jl., vol. 5, p. 216. 

Gustine (S. D.) : How the Yellow Fever Situation was Handled in 
Kenner, 1905. N. O. M. & S. Jl., 1906, vol.. 59, p. 282. 

Heustis (J. W.) : Physical observations, and medical tracts and re- 
searches on the topography and diseases of Louisiana. 8°. New York, 
1817. 

Heustis (Jazeb) : Physical Observations and Medical Pacts and Re- 
searches on the Topography and Diseases of Louisiana. 8vo. New 
York, 1817. 

Hacker: Yellow Fever in Plaquemine. N. O.. M. & S. JL, vol. 10, 
p. 688. 

Hale (J.) : Observations on the fever which prevailed at Alexandria, 
Louisiana, in the autumn of 1830. Transylv. J. M., Lexington, Ky., 
1831, vol. 4, p. 229. 

Heustis (J. W.) : Observations on the disease which prevailed in the 
army at Camp Terre-aux-Boeufs, in June, July and August, of the 
year 1809. Med, Reposit., N. Y., 1817, n. s., vol. 3, p. 33. 

Jones (A. P.) : Yellow fever in a rural district, August to December, 
1853. N. O. M. News & Hosp. Gaz., 1854-5, vol. 1, pp. 180, 205. 

Kelly (Howard A.): The lesson of little things; the conquest of 
yellow fever. Boston, 1907, p. 15, fol. 

Cutting from The Youth's Companion, Boston, 1907, vol.. 81, p. 15. 

Leary (M. F.) : Yellow fever at Greenwood, La.; a case of contagion. 
N. O. M. & S. J., 1873-4, n. s., vol. 1, p. 628. 

Louisiana Bd. cf Health Circular Embodying Brief Directions Appli- 
cable to the Usual Types of Yellow Fever. Aug.. 23, 1878. 4°. New 
Orleans, 1878. 



914 HISTORY OF YELLOW FEVER. 

Lambert (P. A.) : An Essay on Yellow Fever, read before tlie La. 
Medico-Chirurgical Soc. N. O. M. & S. Jl., vol. 1, p. 4. 

Lj^man (J. W.) : Yellow Fever at Franklin, La., in 1853. N. O. M. 
& S. JL, vol. 10, p. 670. 

McKelvey (P. B.) : Yellow Fever a;t Francisville. La. N. O. Med. 
& Sur. JL, 1849-50, vol. 6, p. 64. 

McLeod (M. A.): Yellow Fever in Thibodeaux, La., in 1854. Trans. 
Anier. Med. Assn., 1856, voL 9, p. 682. 

Pbares (D. L.) : Bayou Sara vs. Yellow Fever.. Tr. Mississippi M. 
Assn., Jackson. 1879, vol 12, p. 117. 

Proceedings of three conferences held by the representatives of the 
Mississippi, Alabama and Louisiana State Board of Health, and Marine 
Hispital Service, at Ocean Springs, Miss., September 4, 5 and 6, 1897, 
to determine the . character of the pj-evailing fever. Rep. Bd. Health 
La., 1896-7, Baton Rouge, 1898, p. 29. 

Scruggs (S. O.) : Report on the Epidemics of Louisiana, Mississippi, 
Arkansas and Texas. Trans. American Med Assn., 1856, vol. 9, p. 623. 

Scruggs (S. O.): Yellow Fever at the Village of Cloutierville, La., 
in the years 1853 and 1854. Trans. American Med. Assn., 1856, vol. 

9, p. 704. 

Sternberg (G. M.) et al.: Reports in regard to a form of fever recent- 
ly prevailing on the lower Mississippi River. N. O. M.. & S. JL, 1880-81, 
vol. 8, p. 382. 

Wood (W. B.) : Yellow Fever at Centreville, La., in 1855, with Some 
Remarks on the Disease as it apeared in the Parish of St. Mary, La., 
in 1853, 1854 and 1855. Trans. Amer. Med. Assn., 1856, voL 9, p. 671. 

Tuck (W. J.) : Letter on Yellow Fever. N. O. Med. & Surg. JL, voL 

10, p. 663. 

Yellow fever at Lake Providence, La„ London Med. Times & Gaz,, 
1853, vol. 7, p. 465. 

Yellow fever at Madisonville, La., in 1818. (French.) Tralliet, 
Examen Critique, etc., Relatif a la Fievre Jaune (Lyons, 1830), p. 15. 



915 

MAINE. 

EASTPORT. 

1902. 

For the first and only time in its history, yellow fever 
was brought to the doors of Eastport in 1902. The Brit- 
ish bark Birnam ^Yood from Eio de Janeiro, June 19, in 
ballast for St. John, New Brunswick, anchored in Little 
Machias Bay, Sunday night, August 3, flying signals of 
distress. Dr. Shaw, of Machias boarded the vessel and 
found that the bark had yellow fever on board; three of 
the crew having died and the captain and cabin boy being 
down with the fever. After fumigating the vessel, she 
was towed to St. John, New Brunswick, and arrived at 
quarantine outside Partrdige Island, on August 5. 

There was no diffusion of the disease ashore, 

PORTLAND. 
1801. 

On August 19, 1801, the ship Ocean arrived at Portland 
from Havana via New York, where she had performed 
quarantine twenty days. The vessel had lost several of 
her crew from yellow fever during the voyage, and had 
left some sick at the hospital on Staten Island. 

A merchant of Portland and his clerk who visited the 
ship on business, were attacked shortly afterward (Au- 
gust 24) with a disease which proved to be yellow fever. 
Both recovered. 

The merchant's son, a lad of 12, who had accompanied 
his father on board the ship, next took the disease 
(August 25) and died on the 31st. 

Two of the merchant's laborers were also attacked and 
died on the fifth day after the onset. 

The next cases occurred in the persons of two young 
men, from a remote and healthy part of the State, who 



916 MAINE. 

went on board the Ocean soon after their arrival at Port- 
land, and assisted in remoTing sundry articles from the 
ship's hold. Four days after, they were both attacked 
with yellow fever, but eventually recovered. 

The disease did not sj)read to the other inhabitants of 
Portland, but was confined solely to persons who com- 
municated with the vessel, which proves that the infected 
mosquitoes did not migrate to the shore. 

Total case, 7; deaths, 3. 

In addition to the above cases, it is worthy of note that 
the captain of a packet, who took goods out of the Ocean 
and carried them to Boston, was seized with yellow fever 
on his arrival at the Massachusetts town and died. One 
of his crew, who had assisted him in removing the cargo, 
also sickened and died. ''His skin," says the old chron- 
icler, 'Vas of a deep yellow color." 

1839. 

In 1839, it is again ''a ship from Havana," which brings 
yellow fever to the City of Portland. There were only a 
few cases, confined to the ship's crew. The inhabitants 
of Portland were not affected. 



BIBLIOGRAPHY OF YELLOW FEVER IN MAINE. 

EASTPORT. 

Small: U. S. Public Health Reports, 1902, vol. 17, p. 1871. 

PORTLAND. 

Barker: N. Y. Medical Repository, 1803, vol. 6, p. 78. 

Austin: Trans. American Medical Association, 1877-8, vol. 4, p. 235. 



917 

MARYLAND. 

BALTIMOEE. 

According to Carroll {Old Maryland, 1906, Vol. 2, p. 
17), yellow fever must have been introduced a great 
many times in Baltimore, yet the only important epidemic 
outbreaks of the disease took place in 1794, 1797, 1800 
and 1819. It is notable that all the outbreaks began at 
Locust Point or about the docks and wharves, and they 
can be traced directly or indirectly to the shipping. The 
relative high ground upon which the city is built and 
the distance at the time of the city proper from the 
wharves and shipping, explain why the inter-urban resi- 
dents suffered but little, while those living upon the 
poorly-drained, low-lying districts near the river, were 
compelled upon such occasions to flee for safety. 

Summary of Epidemics. 

1783; 1789. 

Berenger-Feraud (Fievre Jaune, etc., 1890, pp. 57 and 
58), says that yellow fever prevailed for the first time in 
Baltimore in 1783, and reappeared in 1789, but gives no 
details. 

1794. 

The epidemic of 1794 is the first of which any authentic 
information is available. 

According to Carroll (loc. cit., p. 18) who quotes Drys- 
dale as his authority (see Bibliography at the end; of this 
article), the yellow fever epidemic of 1794 first made its 
appearance at two points, remote from each other, viz. : 
at BoAvley's Wharf, in the town, and at Fell's Point. 
Many cases occurred throughout the town, but these 
originated either from communication with Bowley's 
Wharf or the Point, and the infection could be distinctly 
traced to one of those two places. Being puzzled to ex- 



918 HISTORY OF YELLOW FEVER. 

plain wliT the infection was confined to those two places, 
Dr. Drysdale found that the first cases on the Point were 
confined to houses whose cellars Avere filled with stagnant, 
putrid water, and he also found black, putrid and 
offensive water beneath the stores in which the sick re- 
sided at Bowley-s Wharf. Almost all of those who were 
first affected Avere new-comers. Dr. Drysdale describes 
the Point as being low and flat; its streets generally not 
pared, its alleys filthy and the ground marshy in many 
places. The frequent warm rains kept the noxious places 
constantly moist under a hot sun. 

Dr. Carroll observes that we can easily recognize these 
as conditions favorable to the multiplcation of mosqui- 
toes, and the domestic habits of the Stefjomjjia mosquito 
would tend to keep the infection rather closely confined 
to these localities. 

Dr. Drysdale further makes the significant statement 
that remittents were present from a very early period. 
It is more than probable that many of these remittents 
were true yellow fever, because under the belief then pre- 
vailing, that these were simjjly the prevailing tyj^es of 
summer fever, they would not be reported. It is also 
probable that if occasional cases were known to have been 
yellow fever, some physicians would have concealed them, 
from the same motives that prevail to-day. 

Dr. Drysdale saw the first case just before death, on 
the 7th of August at Bowley's Wharf, in the town, and on 
the 14th, 20th, 22nd and 23rd of the same month, he saw 
five additional cases at the same part of the wharf. There 
were also at the same place some other cases which did 
not come under his care. Dr. Drysdale states that there 
was considerable sickness at Fell's Point after the death 
of his ffrst case, and many deaths had occurred suddenly 
or after a short indisposition. An investigation was made 
by three of the most respectable physicians who reported 
that the prevailing fever was the common endemic of the 
season, which visited the Southern and Middle States 
annually, viz. : the bilious remittent fever. The number 
of cases now rapidly increased so that by September 25th, 



MARYLAND BALTIMORE. 919 

about seven weeks, five physicians were attacked and two 
of tliem died. The cases had become so numerous that 
Dr. Coulter visited and prescribed for more than 120 per- 
sons daily. By the end of the month many families had 
sought refuge in the country. During this time the city 
remained unusually healthy, and although some persons 
infected at the Point, died in the cit}^ projDcr, the disease 
failed to spread in that locality. 

The infection is said to have been disseminated by the 
ship TrhdnjjJi, which arrived at FelPs Point about the 
last of June, 1794, with almost all her crew indisposed, 
having previously been moored along side a schooner 
whose captain had died from yellow fever during the 
voyage from the West Indies. 

The total number of deaths ascribed to yellow fever 
during this epidemic was 360. 

The following quotation from Dr. Drysdale's work is 
of significant interest at this time of the known propaga- 
tion of yellow fever by the Stegompia Calojms race of 
mosquitoes : 

^'Locusts were not more numerous in the reign of 
Pharaoh, than mosquitoes through the last few months; 
yet these insects were very rare only a few years past, 
when a far greater portion of Baltimore was a marsh." 

The fact that the mosquitoes were not widely diffused 
through the city, evidently saved Baltimore from a more 
disastrous epidemic. 

1795. 

Mild outbreak; no statistics. 

1797. 

First cases were observed in August ; last, in November. 
Previous to September 17, the fever was confined to cer- 
tain places and to "such as had breathed the air evolved 
from them;" on that day, a strong southeast wind 
"wafted the effluvia in a southwest direction, and diffused 
the infection among the inhabitants in the upper parts 
of Frederick, Gay and Calvert Streets, who became im- 



920 HISTORY OF YELLOW FE\-ER. 

mediately implicated in the horrors of yellow fever." 
{Carroll, loc, cit., p. 21). 
The outbreak was limited and the mortality small. 

179S. 

Sporadic cases; developments unimportant. 

1800. 

Carroll (Old Maryland, 1906, vol. 2, p. 21) is autnority 
for the statement that the epidemic of 1800 was the sever- 
est Baltimore has ever experienced. The mortality from 
yellow fever is recorded to have been 1,19", or about one 
in fifty of the population of 60,000. Again the disease 
began at Fell's Point, on the borders of the Cove, which 
extended from Jones' Falls to the interior. The Faculty 
of Medicine of Baltimore, after investigation, reported to 
the Mayor that in their belief the disease was not im- 
ported but originated in the Cove from the stagnation 
and putrefaction of filth, under a summer's sun. Of 
course, at this enlightened age, we know this theory to 
be wrong and the natural tendency is to incriminate our 
old friend, -'a ship from the West Indies." 

The first two cases appeared on the 2nd of May, an- 
other on the 8th of June, one on the 9th, 10th and 13th ; 
then from the 22nd they became more numerous. It is 
unfortunate that there is no detailed description of this 
epidemic, the most disastrous that Baltimore ever ex- 
perienced. 

1800; 1801; 1802; 1805; 1818. Sporadic cases; no 
statistics. 

1819. 

The next general outbreak took place in 1819 {Carroll, 
lor. cif., p. 21), following the arrival of an infected ship 
from Havana. In a letter to the editors of the Medical 
Repository (1801, vol. 1, p. 351), Dr. Pierre Chatard, of 
Baltimore, writing October 19th, cites the first cases as 
follows : The fever commenced raoins: at Fell's Point in 



MARYLAND BALTIMORE. 921 

the beginning of July, and never ceased there until the 
end of October. It appeared also at Smith's Dock, toward 
the end of July, carrying off five persons whose names are 
given, and others. The persons named had counting 
houses on the dock or in the vicinity. No other cases 
appeared at the dock for two months, at the end of which 
time tAVO more appeared. Dr. Chatard attributes the 
absence of cases during this time to the great quantity of 
lime that had been strewn on the ground, by order of the 
Mayor. The lime was again applied and the cases ceased. 
At Fell's Point the disease raged for three months before 
it subsided. The greater part of the population retired to 
the healthier portions of the city and many of them sick- 
ened and died there, but none of their friends or relatives 
suffered in consequence. 

1820; 1821; 1822. Sporadic cases. No statistics. 

1858. 

Sporadic cases. Ten cases are reported to have oc- 
curred at Fort McHenry, from infected vessels in quar- 
antine. 

1868; 1873. 

Imported cases. No developments. 

1876. 

The last serious outbreak of yellow fever in Baltimore 
took place in 1876. The history of this epidemic is as 
follows {Morris, Trans. American Puhlic Health Associ- 
ation, 1877-8, vol. 4, p. 242) : 

The first case (death) was reported by Dr. Winter- 
nitz, on the 14th of September, 1876. This was followed 
by forty-four cases of the disease, of which forty died. 
Then the authorities, thoroughly alarmed, had all the 
people living in the infected quarter, sick and well, num- 
bering in all, one hundred and fifty persons, removed to 
the Quarantine Hospital, some miles from the city. A 
cordon was placed around the locality; the whole place 
was purified; nearly a hundred cart loads of filthy ac- 
cumulations Avere removed ; the privies were emptied and 



922 HISTORY OF YELLOW FEVER. 

filled up with clay; the homes and clothing of the people 
were cleansed and disinfected, and a certain poirtion of 
the latter destroyed, and every possible source of infection 
was removed. The result of these measures was that not 
a single case of the disease occurred afterwards, and the 
whole trouble disappeared as if by the power of a magi- 
cian's wand. Though one hundred and fifty persons were 
removed to the Marine Hospital, and twenty-five cases 
were treated there, fifteen of which proved fatal, not a 
single one of those engaged in removing the sick — nurses, 
physicians, etc. — contracted the disease. Only one single 
death took place at a distance from the infected district, 
and that was a patient who hacl lived in one of the houses 
in which there had been several cases, and who died twen- 
ty-four hours after leaving it. ^'A ship from the Spanish 
Main" (South America) is accused of having brought the 
infection. 

1878. 

Two deaths on board the May QueeUy from Rio de 
Janeiro. 

1883. 

July 27, four cases on board the ship California^ from 
Vera Cruz. 

1894. 

The steamship Samuel Tyzak, from Havana, arrived on 
August 4, with four cases of yellow fever on board. One 
of the patients died at the Maryland University Hospital, 
and another occupied a bed in one of the wards before the 
nature of his illnes was discovered. 

About the same time, the bark Alien, also from Havana, 
had three cases of yellow fever on board while in the 
quarantine basin. 

Since 1894, no cases of yellow fever have been observed 
in Baltimore or at the quarantine station. 



MARYLAND BALTIMORE. 923 

BIBLIOGRAPHY OF YELLOW FEVER IN MARYLAND. 

BALTIMORE. 

Additional Number to the Letters of Humanitas, together with John 
Hillen's, William Jenkins, and Dr. McKenzie's Letters and other 
Documents, Relative to Polly Elliott's Case; and a Reply to the same, 
hy James Smith, phisician. 8vo. Baltimore, 1801. 

Carroll (J.) : The Epidemics of Yellow Fever in Baltimore. Old 
Maryland, 1906, vol. 2, p. 17. 

Chatard: Notice Succincte du Typhus, etc., qui se manifesta a 
Baltimore au mois de Juillet, 1819. Observateur des Sciences 
Medicales de Marseille, vol. 5, p. 333. 

Chatard: On the Yellow Fever, as it appeared at Baltimore in the 
summer and autumn of 1800. New York Med. Reposit., 1801, vol. 4, 
p. 235. 

Drysdale: Account of the Yellow Fever in Baltimore in 1794. Coxe's 
Phila. Medical Museum, vol. 1, 1804, pp. 22, 121, 241, 361. 

Jameson (H.. G.) : On the yellow fever in Baltimore. Am. J. M. Sc, 
Phila., 1856, n. s., vol. 32, p. 372. 

Johnson (Ed.) : A series of Letters and other Documents relating 
to the late Epidemic or Yellow Fever (1819). 8vo. Baltimore, 1820. 

Kemp. (W. M.) : What Baltimore did m a Sanitary way during the 
yellow fever in Norfolk and Portsmouth in 1855. Tr. M. &, Chir,. Fac. 
Maryland, Bait., 1882, p. 132. 

Late (The) epidemic in Baltimore. Bait. Phys. & Surg., 1876, vol. 
6, p. 37. 

Moores (D.): [Origin of the yellow fever in Baltimore.] Med^ 
Reposit., N. Y., 1801, vol. 4, p. 351. 

Morris (J.) : History of the epidemic in Baltimore in 1876. Am. Pub. 
Health Assn. Rep., 1877-8, Boston, 1880, vol. 4, p.. 243. 

Official statement of the causes of the late epidemic yellow fever, 
in the city of Baltimore, by the District Medical Society of Maryland. 
Med. Reposit., N. Y., 1820, vol. 20, p. 345. 

Opinion of the Medical Faculty of Maryland relative to the 
Domestic Origin of the Pestilential Sickness in Baltimore during the 
hot season of 1800. Medical Repository, 1801, vol. 4, p. 351. 

Reese (D. M.) : Observations on the Epidemic of 1819, as it pre- 
vailed in a part of the city of Baltimore, etc., 12mo. Baltimore, 1819. 

Revere (Jno.): An Account of the Fever which prevailed in certain 
parts of Baltimore during the summer and autumn of 1819, with some 
Remarks on its Origin and Treatment. Medical Recorder, vol. 3, p. 214. 

Rush (B.) : Account of the yellow fever in Baltimore, in 1794. Phila. 
M. Museum, 1804-5, vol. 1, p. 22. 



924 HISTORY OF YELLOW FEVER. 

Series (A) of letters and other documents relating to the late 
epidemic or yellow fever; comprising the correspondence of the mayor 
of the city, the l:oard of health, the executive of the State of Maryland, 
and the reports of the faculty and District Medical Society of Balti- 
more. Also essays of the physicians, in answer to the mayor's circular 
requesting information for the use of the city council in relation to 
the causes which gave origin to this disease. To which is added the 
late ordinance re-organizing the board of health, etc. 8°. Baltimore, 
1820. 



925 

MASSACHUSETTS. 

The Epidemics of 'New England in Colonial Times. 

In 1618, two years before the landing of the Pilgrim 
Fathers at Plymouth, there appeared among the Indians 
of the country, one of the most remarkable epidemics on 
record. So fatal was the pestilence, that the warriors 
"were reduced from nine thousand to a few hundreds.'^ 
The Massachusetts tribe alone was supposed to have lost 
2,700 out of 3,000 persons. {Hutchinson, History of 
Massacliu setts, vol. 1, p. 34). 

The same authority states that in 1621, many places 
which had been populous Indian villages, were found '^all 
deserted — all dead." 

Noah Webster, in his work on Pestilence, attempts to 
decide that this pestilence was the fever which has since 
received the appellation of "yellow fever;" his reliance 
for this opinion being the statement of General Gookin 
{Massachusetts Historical Collections, vol. 1, p. 143), 
which reads as follows : 

"What the disease was which so generally and mortally 
swept them away, I cannot learn; doubtless it was some 
pestilential disease. I discoursed with some Indians that 
were then youths, who say the bodies, all over, were ex- 
ceeding yellow (describing it by a yellow garment they 
showed me) both before they died and afterwards." 

That this was not small-pox (a frequent scourge of the 
aborigines), is evident from several circumstances; but 
the basis (above cited) for the inference that it was yel- 
low fever, is too slight, especially when we remember what 
Webster ignores, that it raged in w^inter, which yellow 
fever never does, at least in Northern latitudes. It was 
most probably a maligna-nt typhus, with bilious compli- 
cations, jaundice and nasal hemorrhages of paludal 
origin. 

At the commencement of the settlement of Plymouth, 
our venerable ancestors suffered very much from sick- 



926 HISTORY OF YELLOW FEVER. 

ness. At the end of three months after thvJT arriTal, 53 
only surTived of the 101 who came in the Maijfloicer. 

"The sick were destitute of almost all the comforts 
which their miserable condition rendered indispensable. 
Their sufferings were increased by the want of well per- 
sons to perform the duties among the sick; there being, 
at one time, not more than six or seven persons in toler- 
able health.*' Thatchers History of Plymouth, p. 32. 

In 1631, small-pox, first breaking out at Saiigtis, spread 
from Xarraganset to Piscataqua, and westAvard to Con- 
necticut Eiver, and swept off entire Tillages of the In- 
dians. When Increase Mather wrote, there were liring 
some old residents, who on that ocacsion helped to bury 
whole families of the natives at the same time. 

At the close of 1633, small-pox again broke out, and 
made great devastations among the unfortunate native 
races of Massachtisetts. Chickatabut, the great sachem 
of the tribe, was among the victims 

Plymouth was again visited with a mortal sickness in 
1631, of which twenty men, women and children died; 
among whom was '"that most excellent and pious man," 
Dr. Samuel Fuller, the first physician of Xew England. 
It must have been occasoned by a fever of domestic origin, 
as the colony had at that time no intercourse with for- 
eign countries, except England. 

Great sickness prevailed among the Indians at Mar- 
tha's Vineyard in 1615. Few escaped. 

In 1617 a malignant fever prevailed, ''occasioned by the 
excessive heat of summer;*' and an epidemic influenza 
passed through the whole country, and universally af- 
fected the colonists and natives ; but it was not very mor- 
tal, ''wherein a special providence of God tippeared, for 
not a family nor but a few persons escaping it; our hay 
and corn had to be lost for want of help ; but such was 
the mercy of God to his people, as few died — not above 
forty or fifty in the Massachusetts and near as many in 
Connecticut." 'Winthrop's Journal, vol. 2, p. 310. 

Another epidemic distemper, similar to that of 1617, 
passed through Xew England in 1655. It began in June, 



MASSACHUSETTS. 927 

and few persons escaped. Among those who died was 
Eey. ^N'^athaniel Eogers, of Ipswich. 

Sickness and mortality throughout New England in 
1658. 

Croup is first mentioned in the annals of the country 
in 1659. Other malignant diseases also prevailed about 
this time. Thirty children died in Eowley, Mass. A day 
of thanksgiving was appointed in Connecticut, for the 
"abatement of the sickness in the country, and a supply 
of rain in time of drought." 

Small-pox was very fatal in Charlestown, Mass., in 
1677. The records state that thirty-one died of the dis- 
ease, one of whom was the Rev. Thomas Shepard. 

In 1678, small-po'X in Boston ; but we have seen no ac- 
ecount of its victims. Seven or eight hundred are said to 
have died of it in Massachusetts. About this time "the 
seasons were unfavorable, and the fruits blasted, while 
malignant diseases prevailed among the people. The sick- 
ness and bad seasons were attributed by o>ur pious an- 
cestors to the irreligion of the times, and to their disuse 
of fasting; and a meeting was held to investigate the 
causes of God's judgments, and to propose a plan of re- 
formation." Webster, vol. 1, p. 203. 

The influenza began in November, 1697, and prevailed 
until February, in Massachusetts. Whole families and 
whole towns were seized nearly at the same time. In the 
following year (1698), a "mortal disease prevailed so 
much, in Fairfield, Connecticut, that well persons were 
not found to take care of the sick and bury the dead. 
Seventy died in three months, out of a population of less 
than one thousand. At the same time, a dreadful mor- 
tality occurred in Dover, New Hampshire. 

Yellow fever prevailed at Hollinston, Massachusetts, 
"of Avhich died, Mr. Stone, the minister, and 14 of his 
congregation." How the fever was introduced, is left to 
conjecture. 

In 1743 an "infectious fever" prevailed in Boston. 
Yellow fever prevailed in New York, Philadelphia, New 
Haven, Conn., and Stamford, Conn., was distressed by a 



928 HISTORY OF YELLOW FEVER. 

malignant dysentery, which swept away 70 inhabitants 
out of a few hundreds. 

^^About the same time (the precise year is not known) 
a malignant epidemic disease laid waste the Indian tribes, 
which, from the description given by the traders, would 
appear to be, though it probably was not, the infectious 
Yellow^ Fever. In consequence of it, the Senecas removed 
their quarters two or three times in a few years. The dis- 
ease was said to have been confined to the Indians, the 
white people living and trading with them not being 
affected. (Griscom, p. 4). 

The Mohegan tribe, between New London and Norwich, 
were ^'wasted by the same malady'' in 1746. From an 
account given by a Mohegan priest, ''a man of good sense 
and integrity," as related by a Dr. Tracy, of Norwich, 
who attended them as a physican, and was the only white 
man affected, the following were the symptoms of this 
disease: The patient first complained of a severe pain 
in the head and back, which was followed by fever; in 
three or four days his skin turned as yellow as gold; a 
vomiting of black matter took place, and generally a bleed- 
ing of the nose and mouth, which continued till the 
patient died. One hundred of the tribe died.." 

Summary op Yellow Fever Years. 
BOSTON. 

1621. According to Dowler (1853, p. 7), first appear- 
ance of yellow fever in Boston. No authentic statistics. 

1693. An English squadron under Admiral Wheeler, 
after remaining a month at Barbadoes and twenty-one 
days at Martinique, brought yellow fever to Boston, where 
it caused great mortality. {Hutchinson^ s History of New 
England, vol. 5, p. 110). 

1795. Infected by vessels from the West Indies. Only 
a few cases. The fever did not spread to the inhabitants. 

1796. Yellow fever broke out on August 26, the first 
death taking place on the 29th. Source of infection 



MASSACHUSETTS. 9ft9 

obscure. Warren (see Bibliography), like the majority 
of the good old souls of the period who have written on 
yellow fever, maintains that ^'it was caused by noxious sub- 
stances exhaled into the atmosphere from putrefying ani- 
mal or vegetable matter or both." Only 130 deaths are 
recorded, which proves that the disease was undoubtedly 
confined to imported cases. 

1798. Serious outbreak. Deaths, 200. 

1799; 1800. Imported cases; no important develop- 
ments. 

1801. The master of a packet plying between Boston 
and Portland, Maine, who took goods out of a ship in- 
fected with yellow fever, which was at the latter port, 
was taken ill with the disease on his arrival at Boston, 
and died shortly afterwards. One of his sailors sickened, 
also at the same time and died. The marked yellow color 
of the skin of the latter is specially mentioned by the 
chroniclers of this episode {Banker^ New York Medical 
Repository, 1803, vol. 6, p. 78). 

The fever did not spread to the inhabitants of Boston. 

1802. Limited outbreak. Deaths, 60. 

1805; 1819; 1858. Infected by the shipping. No im- 
portant developments. 

1885. On September 24, the steamship Craighill, from 
Colon, Panama, anchored in Boston harbor. Four cases 
of yellow fever were discovered on board, and were trans- 
ported to Gallup's Island Hospital, where they eventually 
recovered. The captain of the vessel had died from yellow 
fever during the voyage. 

The city was not infected. 

CHELSEA. 

1877. Two yellow fever patients were disembarked at 
the Chelsea Hospital, on December 12, from the ship 
Laura Wilson, from San Domingo City. One of the 
patients died on the 16th, the other recovered. 

HOLLISTON. 

1741. Holliston, 25 miles from Boston, was the scene 
of a mild outbreak in 1741. Deaths, 15. 



930 HISTORY OF YELLOW FEVER. 

NANTUCKET. 

1763. Deaths, 259. 

NEW BEDFOED. 

1800; 1801; 1821. Yellow fever outbreaks. No record 
of cases and deaths. 

NEWBUKYPOKT. 

1796. According to Brockway {National Board of 
Health Bulletin, 1881-2, toI. 3, p!^ 179), yellow feyer yis- 
ited Newburyport on several occasions. As early as 1793, 
at which time yellow fever was devastating Philadelphia, 
Governor Hancock, of Massachusetts, issued the follow- 
ing proclamation : 

"Whereas a dangerous and infectious disease is prevalent at this 
time in the city of Philadelphia, and it being highly expedient that 
effectual measures should be adopted to prevent its introduction with- 
in this commonwealth [Massachusetts], 

"I do, therefore, in pursuance to a resolution passed by the two 
branches of the legislature this day, require all sheriffs and their 
deputies, the selectmen and constables of the several towns in this 
commonwealth, to take effectual measures for examining all persons, 
with their baggage and other effects, by land or water, coming from 
Philadelphia or any other infected place, and where there is reason to 
apprehend that the infection may be communicated, that they take 
such measures as the law in such cases made and provided directs for 
detaining and cleansing the persons and baggage from which 
danger may be apprehended, so as to effectually prevent the intro- 
duction and spreading of said infectious disease among the good 
people of this commonwealth." 

(Signed, etc.) 

Newburyport, in response to this proclamation, and in 
view of the great mortality from yellow fever raging at 
Philadelphia, the accounts published from there, stating 
that one hundred persons were buried in one day at this 
time, and in the general alarm which prevailed, issued 
this "notification:" 



MASSACHUSETTS NKWBURYPORT. 931 

"Whereas a dangerous and infectious disease is now prevailing, 
not only in Philadelphia, but also in the leeward and winward West 
India islands, this is to forbid all pilots, and others, on penalty of 
the law, from bringing any vessel from Philadelphia higher up t*he 
Merrimac River than the Black Rocks, or any vessel from a foreign 
port to any wharf in this town, but let them remain in the stream 
until examined by the health officer and certificate from him be ob- 
tained certifying her being, in his opinion, free from infection. 

"By order of the selectmen. 

"Published September 23, 1793." 

The quarantine ground, so called, was about a mile and 
a half below the town. 

The selectmen also reminded the inhabitants, at this 
date, to give special attention to cleanliness and recom- 
mended the most scrupulous examination of the streets, 
that no dead carcasses or other offensive things are suf- 
fered to remain, and to the '^necessity of causing all drains 
and offensive, stagnant waters in yards or near houses 
to be cleansed," etc. 

The selectmen of Newburyport, in the summers of 1794 
and 1795, urge a strenuous enforcement of the quarantine 
regulations, as the yellow fever was prevailing in several 
of the cities in the United States, especially in New 
Haven, in 1784, to such an extent as to break up the col- 
lege ; and, as early as May 14, 1795, the pilots and masters 
were ordered by the selectmen of Newburyport ^'not to 
bring any vessel above Black Kocks then having, or dur- 
ing the voyage having had, any person on board infected 
with small-pox or any pestilential disease, or conning from 
any port where such diseases prevail, until liberty is ob- 
tained from the selectmen. On hoisting a color on the 
shrouds (of the vessel) a proper person will attend on 
board to see the vessel well cleansed and to make report 
of her situation." 

Summary of Epidemics. 

1796. 

The same authority quoted above (Brockway) states 
that yellow fever made its appearance in Newburyport in 
1796, causing great elarm, but it was not until about the 



9 Si HISTORY or YELLOW FEVER. 

middle of August that it >Yas publicly noticed, although 
it commenced m June, and from the middle of that month 
until the 5th of October, fifty-fiye faltal cases were re- 
ported. Tradition says that some of the prominent citi- 
zens of the town at this time took steps to secure the 
services of an ex]3erienced French physician, Dr. Francis 
Yergnies, whom the local paj)er mentioned as haying ar- 
rived in Newburyport in the summer of this year, from 
the island of Guadaloupe. That this gentleman rendered 
important service was evident, as the town at a public 
meeting of the citizens, in April of the following year, 
1797, unanimously voted "that the thanks of the town be 
given to Dr. Vergnies, for his prompt assistance and 
advice the last summer (1796), when the town was visited 
with a malignant disorder." 

Dr. Vergnies continued his residence in Newburyport 
in the general practice of his medical profession until his 
death in 1830. 

These cases of yellow fever are the first which Dr. 
Brockway found publicly acknowledge as such, and re- 
ported in the history of the town. One of the historians 
of Newburyport remarks that "this malignant fever, a 
disease then practically unknown to the members of the 
medical faculty here, but which was thought to be sim- 
ilar^ if not identical with the yellow fever of the South, 
first appeared in a house on Water Street, etc., in the 
immediate neighborhood of one of the wharves in the har- 
bor, and its ravages were confined to a narrow locality 
and short distance in this street, which was closeci or 
'chained up' to prevent passage." It was conjectured by 
some that the disease originated on the spot, but the most 
reasonable conclusion was that it was brought in a ves- 
sel from one of the West India islands ; and this opinion 
was generally entertained. That the fever was caused bv 
decayed fish in the dock was believed in by many, there is 
no doubt, as the town, at a special meeting called July 
21, 1796, chose an "inspector of police" to remove all 
nuisances, and to "prohibit fish being thrown into the 
river," etc. Among the victims to this disorder, which 
caused great excitement in the town, and widespread 



MASSACHUSETTS NEWBURYPORT. 93S 

alarm, were several prominent citizens of the town, in- 
cluding an eminent resident physician, Dr. J. Bernard 
Swett. The fever disappeared with the frost. 

In 1797, July 27, the town voted to choose a health 
officer to carry into effect a law of the commonwealth 
passed the month previous, '^to prevent the spreading of 
contagious sickness." Public attention in this town was 
again called in the following summer to the danger from 
yellow fever by its prevalence in Philadelphia, New York, 
Albany, Newport, Boston and several other places at the 
North, up to the middle of September. 

1799. 

In the summer of 1799 there was a return of yellow 
fever at Newburyport, which the petitioners for a special 
town meeting called "an alarming mortal sickness ;" and 
a health committe was chosen to adopt measures to pre- 
vent the fever from spreading, and to secure a more rigid 
quarantine. 

The reappearance of the yellow fever this summer in 
Philadelphia caused general alarm, and in this town the 
fear was not groundless, as the health committee reported 
nine persons "as having died of malignant fever'' up to 
July 23. The health officer, meantime, had ordered the 
free use of unslacked lime in the streets of the town, and 
wherever there was any accumulation of filth, "and par- 
ticularly in vaults." Up to the 6th of August there ap- 
pear to have been fifteen fatal cases, and the health com- 
mittee reported on that day "that the fever had not been 
communicated except in the vicinity of the lower Long 
Wharf," and they recommend that those persons who have 
left that neighborhood remain away until notified by tlie 
committee. A week later several of the traders advertise 
that they have returned to the town with their goods to 
their places of business in Water Street. 

The fever in this instance was supposed to have been 
brought into town by a vessel which arrived from St. 
Thomas on the 29th of June, and is reported in the news- 



9S4 HISTORY OF YELLOW FEVER. 

paper as having discharged her cargo at the wharf men- 
tioned above, and that nearly all those who had died, had 
labored on board of this vessel. 

1829. 

Two cases, in 1829, close the history of yellow fever in 
NewburyiDort. A prominent physician of the town. Dr. 
Bradstreet, who was then Health Officer of the port, vis- 
ited a vessel ''from the South,-' which was then at quar- 
antine and contracted yellow fever, and died shortly after 
the onset. His daughter shared the same fate. 

The disease did not spread to the other inhabitants of 
the place. 

SALEM. 

1798. Limited outbreak. No authentic statistics. 

BIBLIOGRAPHY OF YELLOW FEVER IN MASSACHUSETTS. 

BOSTON. 

Ayer (J.) : Yellow fever in Boston. Extr. Rec. Bost. Soc. M. Improve. 
(1856-9), 1859, vol. 3, p. 255. Also: Boston M. & S. J., 1858-9, vol. lix, 
p. 140-143. 

Brown (Samuel): An Account of the Pestilential Disease which 
prevailed at Boston in the summer and autumn of 1798. Medical 
Repository, vol. 2, p. 390. 

Brown (S.) : A Treatise on the Nature, Origin, and Progress of the 
Yellow Fever, especially as it has prevailed in Boston. 8vo. Boston, 
1800. (See a Review of this volumns in Medical Repository, vol, 4, 
1901, p. 63.) 

Case of the Ship Ten Brothers; being the Report of a Committee of 
the Board of Health, unanimously accepted, and published by order 
of the Board. Boston, 1819. 

Glover (M. W.): Yellow Fever. Invasions of the Disease (in Bos- 
ton) in Early Times. Yellow Fever Institute Bulletin, No. 2, 1902. 

Ingalls: Weekly Reports to the editors of Medical Repository of 
New York, on the malignant Yellow Fever in Boston in 1819. Medical 
Repository, vol. 10, p. 256. 

Interesting (An) account of the plague, yellow fever, etc., as they 
have prevailed in different countries; printed at the request of the 
Boston Board of Health. 8°. Boston, 1820. 



MASSACHUSETTS. 935 

Page (W. H.) : Yellow fever in Boston. BosLon M. & S. Jl., 1870, 
vol. Ixxxiii, p. 253. 

Rand: Of the Epidemic lately prevalent in Boston (1798). Medical 
Repository, 1899, vol. 2, p. 486. 

Rand and Warren: Account of dissections of bodies dead of ttie 
late malignant epidemic at Boston. Ibid., 249-252. Also: Mem, Am. 
Acad. Arts & Sc, Cambridge, 1804, vol. 2, pt. 2, p. 130-136. 

Report of the Joint Special Committee of the House of Representa- 
tives of Massachusetts, to whom were referred the memorials of the 
Massachusetts Medical Society, and American Statistical Association, 
etc., for a Sanitary Survey of the State. 8vo. 1849. 

Warren (J.) : Yellow fever in Boston. Med. Communicat. Mass. M. 
Soc, Boston, 1809-13, vol. 2, p. 462. 

Yellow Fever in Boston in 1819; to which is added a Note by Dr. 
George Hayward on the same subject. The New England Journal of 
Medicine and Surgery, 1819, vol. 8, p. 380. See also: North American 
Review, vol 10, p. 395. 

GENERAL. 

Buel (W.) : An Account of the febrile disorders which prevailed in 
Sheffield, in the State of Massachusetts, in the years 1793, 1794 and 

1795. In: Webster (N.) : Collection of papers on fever. 8°. N. Y., 

1796, p. 53. 

Coffin (C.) : An account of the pestilential fever which prevailed at 
Newbury Port, State of Massachusetts, in 1796. Med. Repository, N. 
Y., 1797-8, VOL 1, p. 504. 

Parrish (J.) : Remarkable account of the yellow fever as it prevailed 
among the Indians on the Island of Nantucket, in 1763-64. N. Jersey 
M. Reports, Burlington, 1852, vol. 6, p. 107. 



936 

MICHIGAN. 

DETROIT. 

1878. 

A solitary case, "imported from the South," is the only 
record for Michigan. The incident happened during the 
great epidemic of 1878, which devastated the Southland. 
Our authority does not state whence the refugee came, 
but simply records the fact that he fled from some 
Southern city to escape the pestilence, and that he died 
shortly after reaching Detroit. (Vide Annual Report 
Michigan State Board of Health, 1879, pp. 221, 224). 



937 

MISSISSIPPI. 

ANGUILLA. 
1905. Cases, 1 ; deaths, 0. 

BAEKLEY. 
1897. Cases, 10; deaths, 4. 

BAY ST. LOUIS. 

1820. Cases, 280. 

1830. No record of cases and deaths. 

1835. Cases, 9; deaths, 1. 

1853. No record of cases and deaths. 

1878. Population, 3,000. Infected by New Orleans. 
First case, August 11; last case, December 24; first death, 
August 15. Cases, 630 ; deaths, 82. 

1897. Cases, 40; deaths, 4. 

BEACHLAND. 

1878. Deaths, 24. 

BELLE FONTAINE. 

1878. No record of cases and deaths. 

BENTON. 

1853. No record of cases and deaths. 

1878. First case, October 11. Cases, 3; deaths, 1. 

BILOXI. 

1702. Tradition says that yellow fever was present in 
Mississippi during the early years of the eighteenth cen- 
tury. The biographer of Iberville, in his memoirs, states 
that he had yellow fever at Biloxi in 1702, which made 



938 HISTORY OF YELLOW FEVER. 

such ravages on his constitution as to cause his return 
to France for the purpose of restoring his shattered 
health. This ^^as the first appearance of yellow fever on 
the Gulf Coast of the United States. 

1702 ; 1839 ; 1817 ; 1853 ; 1858. Yellow fever years. Xo 
record of cases and deaths. 

1878. Population, 2,000. Infected by Xew Orleans. 
First death, August 17 ; last death, November 23. Cases, 
600 ; deaths, 15. 

1897. Cases, 592; deaths, 27. 

1905. A few imported cases. Xo developments. 

BLUFF SPEIXGS. 

1873. Population, 200. First case, September 9; 
deaths, 9. 

BOLTON. 

1878. Population, 200. First death, August 12. Cases, 
141; deaths, 31. 

BOVIXA. 

1878. Population, 100. Deaths, 7. 
BRANDON. 

1853. Population, 1,200. Infected by Vicksburg. First 
case, September 18; first death, September 23; last case, 
December 3 ; last death, December 3. Cases, 13 ; deaths, 9. 

1851. First case, September 23; last case, November 
18. 

BROWN'S PLANTATION. 

1878. Infected by Canton, Miss. First case, August 
13 ; first death, August 18. Cases, 21 ; deaths, 1. 

BRYAN. 

1878. Infected by New Orleans. First case, Septem- 
ber 29. Cases, 10 ; deaths, 1. 



Missisisippi. 939 

BYRAM. 
1878. No record of cases and deaths. 
CANTON. 

1855. No record of cases and deaths. 

1878. Population, 3,000. Infected by New Orleans. 
First case, August 1; last case, December. First death, 
August 19. Cases, 924; deaths, 180. 

1898. First case, October 10; deaths, October 28. 
Cases, 9; deaths, 0. 

CAESON'S CITY. 

1879. No record of cases and deaths. 

CARDIFF LANDING. 

1878. Deaths, 8. 

CARROLLTON. 
1878. No record of cases and deaths. 

CAYUGA. 

1878. Cases, 38; deaths, 9. 
• 1897. Cases, 25; deaths, 1. 

CENTERVILLE. 

1899. Cases, 2; deaths, 0. 

CLIFTON. 
1853. No record of cases and deaths. 

CLINTON. 

1897. Cases, 42; deaths, 2. 

1898. First case, October 8 ; last case, October 15. 
Cases, 40 ; deaths, 0. 



940 HISTORY OF YELLOW FEVER. 

COOPEE'S WELLS. 

1855. Infected by New Orleans. First case, August 
23 ; first death, August 31. Cases, 70 ; deaths, 13. 

CONCOEDIA. 

1879. Population, 250. Number who fled, 130. First 
case, August 26; first death, August 31; last case, Octo- 
ber 24. Cases, 75; deaths, 20. 

COKINTH. 

1873. Cases, 3 ; deaths, 0. 

COUNTY FARM. 

1897. Cases, 2; deaths, 0. 

COX LANDING. 
1878. Cases, 12 ; deaths, 4. 

CRYSTAL SPRINGS. 

1898. First case, October 11; last case, October 21. 
Cases, 7; deaths, 0. 

DRY GROVE. 

1878. Infected by Brown's Plantation. First case, 
September 2 ; first death, September 7. Cases, 75 ; deaths, 
41. 

DUCK HILL. 

1878. Cases, 36 ; deaths, 14. 

DURANT. 

1878. Deaths, 1. 

1897. Cases, 1 ; deaths, 1. 



• Mississippi 941 

EDWARDS. 

1878. Deaths, 3. 

1897. Cases, 455; deaths, 29. 

1898. First case, September 27; last case, October, 15. 
Cases, 12; deaths, 1. 

ENOKA. 

1905. Cases, 1; deaths, 0. 

EUCUTTA. 

1898. First case, June 24; last case, June 24. Cases, 
1 ; deaths, 0. 

FAYETTE. 

1898. Cases, 5 ; deaths, 0. 

FLOE A. 

1899. No record of cases and deaths. 

FORT ADAMS. 
1839. Infected by New Orleans. 

FRIAR'S POINT. 

1878. Population, 550 ; first case, August 17 ; last case, 
November 1. Cases, 25; deaths, 7. 

GAINSVILLE. 

1878. Cases, 5; deaths, 2. 

GARNER STATION. 

1878. Population, 200. Cases, 31; deaths, 13. 

GOODRICH LANDING. 

1878. Population, 1509. First case, August 1. Deaths, 
42. 



942 HISTORY OF YELLOW FEVER. ^ 

GRAND GULF. 

1839. No record of cases and deaths. 

1853. Infected by Port Gibson, La. First case, Sep- 
tember 10. 

GRAND PLAIN. 

1878. No record of cases and deaths. 

GRAVEL PIT. 
1878. Population, 85. Cases, 20. 

GREENVILLE. 

1853. Population, 300. Number who fled, 100. First 
case, September. Cases, 17; deaths, 9. 

1878. Population, 2,300. First case, August 18; last 
case, November 10; first death, August 24; last death, 
November 15. Cases, 1,000 ; deaths, 400. 

GRENADA. 

1878. Population, 2,500. First case, July 26; first 
death, July 31. Cases, 1,040 ; deaths, 326. 

1878. Cases, 87; deaths, 17. 

GULMAN STATION. 

1878. Infected by Vicksburg. 

HANSBORO. 

1879. First case, June 17. Cases, 2. 

HAMBURG. 
1905. Cases, 50; deaths, 8. 



MISSISSIPPI. 94S 

HANSBOEO. 

1878. Infected by New Orleans. First case, August 
31 ; last case, January 19 ; first death, September 24 ; last 
death, December 24. Cases, 200; deaths, 16. 

1905. Cases, 5; deaths, .0. 

HAKRISON. 

1898. First case, October 6; last case, October 30. 
1905. Cases, 2; deaths, 0. 

HATTIESBURG. 

1898. First case, October 8 ; last case, October 21. 

HEEMANVILLE. 

1898. First case, October 4; last case, October 13. 
Cases, 2; deaths, 0. 

HENDERSON'S POINT. 

1897. Cases, 3 ; deaths, 0. 

HERNADO. 

1878. Population, 1,200. First case, August 15; last 
case; August 21. Cases, 240; deaths, "80. 

HINDS COUNTY. 
Convict Camp. 
1897. Cases, 6; deaths, 0. 

HOLLY SPRINGS. 

1873. Infected by Memphis. Only a few imported 
cases. 

1878. Population, 3,000. First case, August 18 ; first 
death, August 25. Cases, 1,369; deaths. 309. 



944. HISTORY OF YELLOW. FEVER. 

HOEN LAKE. 

1878. Cases, 30; deaths, 17. 

1879. A few imported cases. 

lUKA. 

1878. Infected by Memphis. First case, September 
18 ; first death, September 27. Cases, 6 ; deaths, 3. 

JACKSON. 

1853. Population, 3,000. First case, August 21; first 
death, September 5. Cases, 350; deaths, 112. 

1854. Sporadic cases. 

1878. Population, 2,250. Infected by New Orleans. 
First case, August 26 ; last case, December 4 ; first death, 
August 31; last death, November 28. Cases, 480; deaths, 
86. 

1888. Cases, 15; deaths, 5. 

1898. First case, September 10: last case, November 
10. Cases, 208; deaths, 11. 

1899. Cases, 61 ; deaths, 9. 

KING'S POINT. 

Cases, 92; deaths, 6. 

LAKE. 

1878. Population, 325. Infected by Vicksburg. First 
case, August 24-; first death, September 5. Cases, 300; 
deaths, 86. 

LA WHENCE STATION. 

1878. Cases, 16; deaths, 5. 

LEBANON. 
1878. First case, August 29. Cases, 90; deaths, 10. 



MISSISSIPPI. 945 

LEOTA LANDING. 

1878. Infected by Greenville. First case, November 
21; last case, November 21; first death, November 26; 
last death, November 26. Cases, 1; deaths, 1. 

LIVINGSTON. 

1878. Infected bv Canton. First case, August 28. 
Cases, 15; deaths, 10. 

LOGTOWN. 

1878. Cases, 40; deaths, 9. 

LONG BEACH. 

1905. Cases, 1 ; deaths, 0. 

LUMBEKTON. 

1905. Cases, 1; deaths, 0. 

MADISON. 

1878. Population, 50. A few imported cases. > 

McCOMB CITY. 

1878. Population, 1,000. First case, September 28; 
first death, October 2. Cases, 63 ; deaths, 21. 

McHENRY. 

1897. Cases, 30 ; deaths, 1. 

1898. First case, June 9 ; last case, June 29. Cases, 
22; deaths, 0. 

McNIAKY. 

1878. Cases, 36; deaths, 9. 



946 HISTORY OF YELLOW FEVER. 

MEKIDIAN. 

1898. First case, October 15; last case, October 17. 
Cases, 3; deaths, 0. 

MICHIGAN CITY. 

1878. Cases, 2; deaths, 2. 

MISSISSIPPI CITY. 

1878. Infected by New Orleans. First case, August 
21; last case, December 10. Cases, 200; deaths, 15. 

1879. Infected by New Orleans. First case, July 7; 
first death, July 16. 

1899. Cases, 27; deaths, 2. 
1905. Cases, 71; deaths, 0. 

MOSS POINT. 

1905. Cases, 3; deaths, 0. 

MT. PLEASANT KOAD. 

1879. No statistics. 

MULATTO BAYOU. 

1878. Cases, 1; deaths, 1. 

NATCHEZ. 

1817. First case, September — ; last case, November 9. 
Deaths, 9. 

1819. First case, September — ; last case, December 
— . Deaths, 180. 

1823. First case, August 10; last case, October 18." 
Deaths, 312. 

1825. Deaths, 130. 

1827. No statistics. 



MISSISSIPPI. 947 

- 1828. Deaths, 90. 

1829. First case, September 1; last case, November. 
Deaths, 90. 

1837. First -case, September 8; last case, November 25. 
Deaths, 280. 

1839. First case, September — ; last case, November. 
Deaths, 235. 

1811. No statistics. 

1848. First case, June — ; last case, November. 

1853; 1854; 1855; 1858. No statistics. 

1898. Cases, 37 ; deaths, 4. 

1900. No statistics. 

1905. Cases, 143 ; deaths, 7. 

NITTA YUMA. 

1897. Cases, 27; deaths, 11. 

OAK GEOVE. 

1879. Infected by Memphis. 

OCEAN SPKINGS. 

1878. Population, 600. Infected by New Orleans. 
First case, August 15 ; last case, December 2 ; first death, 
August 18; last death, Deceaiber 5. Cases, 175; deaths, 
SO. 

1897. Cases, 23; deaths, 6. New Orleans was in- 
fected from this focus and experienced a serious epidemic. 

OKOLONA. 

1878. First case, August 10. Cases, 3 ; deaths, 1. 

ORWOOD. 

1898. First case, August 31; last case, October 27. 
Cases, 100; deaths^ 5. 



948 HISTORV OF YFLLOW FEVER 

OXFOKD. 

1898. First case. September 21; last case, October 27. 
Cases, 86; deatlis, 12. 

OSYKA. 

1878. Population. 925. Infected ])y Xew Orleans. 
First case, JiiIt 27: first death. August 15. Cases, 300; 
deaths, 45. 

1900. Sporadic cases. 

PASCAGOULA. 

1817. Xo statistics. 
1875. Deaths, 60. 
1878 ; 1893. Xo statistics. 
1897. Cases, 35; deaths, 2. 

PASS CHEISTIAX. 

1813; 1817; 1855; 1858. Xo statistics. 

1878. Population. 2.000. Infected by Xew Orleans. 
First case, August 29 ; last case, December 1 ; firr't death, 
September 1; last death, Xovember 22. Cases, 199; 
deaths, 23. 

1879. Xo statistics. 

. PEAPLIXGTOX. 

1878. Cases, 201 ; deaths. 2-1. 
1905. Cases, 2 ; deaths. 0. 

PEEKIXSTOX. 

1897. Cases, 1; deaths, 0. 

1898. First case, June 22 ; last case, June 22. ._ ases 
1; deaths, 0. 

PETIT GFLF HILLS. 
1853. Xo statistics. 



MISSISSIPPI. 949 

POPLAEVILLE. 

1898. First case, October 9; last case, October 23. 
Cases, 24; deaths, 1. 

POET GIBSON. 

1853. Infected by New Orleans. First case, August 
15; first death, August IT. 

1878. Population, 1,400. First case, August 3; first 
death, August 8. Cases, 620; deaths, 115. 

1898. First case, October 6; last case, October G. 
Cases, 1; deaths, 1. 

1905. Cases, G3; deaths, 2. 

QUARANTINE. 

1878. Cases, 5; deaths, 2. 

1884. Infected by Colon. Cases, 1 ; deaths, 0. 

1888. Infected by ship Maria, from Havana. Cases, 3; 
deaths, 0. 

1890. Cases, 6; deaths, 2. 

1891. Infected by Chandeleur. Cases, 12; deatlii;. 1. 

1892. Cases, 4; deaths, 0. 

1893. Cases, 3; deaths, 1. 
1895. Cases, 3. 

1897; 1898; 1899. Cases from infected vessels. 
1903. Cases, 4 ; deaths, 2. 
1905. Cases, 41; deaths, 1. 

EEFUGE LANDING. 

1878. First case, September 9; first deatlu September 
29. Cases, 19 ; deaths, 11. 

QUEEN HILL. 

1898. First case, October 15; last case, October 15. 
Cases, 1; deaths, 1. 



950 HISTORY OF YELLOW FEVER 

EIDGELAND. 

1898. First case, October 8; last case, October IT. 
Cases, 7; deaths, 0. 

EOCKY SPEINGS. 

1878. Deaths, 38. 

EODNEY. 

1829. No statistics. 

1843. First case, September 6. 

1847. 'No statistics. 

1853. Sporadic cases. 

EOSETTA. 

1905. Cases, 32; deaths, 7. 

EOXIE. 
1905. Cases, 16 ; deaths, 6. 

SCOTT'S. 
1878. Population, 50. 

SCEANTON. 

1878. First case, October 5; first death, October 11, 
Cases, 60 ; deaths, 20. 

1897. Cases, 363; deaths, 18. 
1905. Cases, 17; deaths, 0. 

SSNATOBIA. 

1878. Population, 1,400. Cases, 26; deaths, 7. 

SHIELDSBOEOUGH. 

1820. First case, August 20. 

1828. No statistics. 

1829. First case, August 5. Cases, 46 ; deaths, 8. 
1839. No statistics. 



MISSISSIPPI. 951 

SMITH'S STATION. 

1878. Infected by Vicksburg. Cases, 16. 

SOEIA. 

1905. Cases, 2 ; deaths, 0. 

STAEKYILLE. 

1898. First ease, October 6; last case, October 18. 
Cases, 9; deaths, 0. 

STONEVILLE. 

1878. Population, 50. Infected by New Orleans. 
Cases, 23; deaths, 15. 

SULPHUK SPEINGS. 

1878. Infected by Canton. First case, August 23; 
first death, August 28 ; last death, October 26. Cases, 15 ; 
deaths, 5. 

SENATOBIA. 

1878. Population, 1,200. Infected by Grenada. First 
case, September 1. Cases, 26; deaths, 7. 

SUMMIT. 

1878. Deaths, 4. 

SUMKALL. 

1905. Cases, 1; deaths, 0. 

SUNFLOWEK. 

1878. Cases, 48; deaths, 15. 

TAYLOR. 

1898. First case, August 1; last case, October 21. 
Cases, 106; deaths, 14. 



952 HISTORY OF YELLOW FEVER. 

TEEEEXE. 

1878. Cases, 12; deaths, 4. 

TEEEY. 

1878. Population, 225. Cases, 10; deallis, 5. 

TOUGALOO. 

1898. First case, October 16; last case, October 17. 
Cases, 2; deaths, 0. 

TOULXE. 

1878. Xo statistics. 

YICKSBUEG. 

1839. Infected by Xew Orleans. Deaths, 50. 

1841; 1847. Xo statistics. 

1853. Population, 4,000. Infected by Xew Orleans. 
First case, JuIt — ; first death, August 1. 

1858; 1871. ^Xo statistics. 

1878. Infected by Xew Orleans. First case, July 21 ; 
last case, December; first death, July 24; last death, 
X^'ovember 21. Cases, 5,000; deaths, 872. 

1905. Cases, 185 ; deaths, 28. 

WAEDVILLE. 

1898. Scattered cases. 

WASHIXGTOX. 

1825. First case, August; last case, Xovember. 
Deaths, 52. 

WATEEFOED. 

1898. First case, September 9; last case, October G. 
Cases, 2 ; deaths, 0. 



MISSISSIPPI. 953 

WATER VALLEY. 

187l. i*opulation, 3,000. First case, August 9; first 
death, August 30. Cases, 200; deaths, 64. 

1898. First case, October 7; last case, October 21. 
Cases, 12; deaths, 0. 

WAVELAND. 

1897. Cases, 4; deaths, 0. 

1898. First case, October 10; Last case, Ov-tober 18. 
Cases, 20 ; deaths, 1. 

W. PASCAGOULA. 

1897. Cases, 8; no deaths. 

WHITZELL'S LANDING. 

1877. No statistics. 

WINONA. 

1878. Population, 1,500. Infected by Grenada. First 
case, August 9. Deaths, 3. 

WINTERVILLE. 

1878. Infected by Greenville. First case, August 28; 
first death, September 15. Cases, 151; deaths, 20. 

WOODVILLE. 

1844 ; 1852. No statistics. 

1853. First case, August 9; first death, August 13. 
1855. First case, August 27; first death, September 2. 
1858. ^o statistics. 

1898. First case, October 6; last case, October 6. 
Cases, 1; deaths, 0. 



954 HISTORY OF YELLOW FEVER. 

YAZOO CITY. 

1853. Populatiori, 2,000. First case, August 28; first 
death, September 1. 

1878. Population, 2,500. Infected by Vicksburg. 
First case, September 15; first death, September 21. 
Cases, 17; deaths, 9. 

1898. First case, October 6; last case, November 10. 
Cases, 26; deaths, 0. 

BIBLIOGRAPHY OF YELLOW FEVER IN MISSISSIPPI. 

Anderson (E. H.) : The late Jackson fever, and previous epidemics 
elsewhere. Memphis Med. Monthly, 1888, vol. 8, p. 545. 

Anderson (E. H.): Some remarks upon our recent invasions of 
yellow fever, by an octogenarian M. D,. Memphis M. Monthly, 1897, 
vol. 17, p. 549. 

Archinard (J. J.): The yellow fever at Ocean .Springs, Miss., 
report of a case and autopsy. N. O. M. & S. Jl., 1897-8, vol. 1, p. 258. 

Ballard (J. C): In regard to yellow fever at Hattiesburg, Miss., a 
criticism of Rev. Mr. Peebles. Med. News, N., Y., 1898, vol. 73, p. 663. 

Beazley (J. S.) : An account of the Epidemic Yellow Fever at 
Cooper's Well, Miss., in 1855. Trans. Amer. Med. Assn., 1856, vol. 9, 
p. 685. 

Cartwright (A) : Post-mortem examinations in the yellow fever of 
Natchez. N. O. M. & S. Jl., March, 1857, p. 649. 

Cartwright (Samuel A.): On the yellow fever of Natchez, Miss., in 
1847. N. O. M. & S. Jl., vol. 5, p. 225. 

Cartwright (S. A.): The yellow fever at Natchez in all its bearings 
on the quarantine question and yellow fever a:t New Orleans. N. O.. 
M. News & Hosp. Gaz., 1855-6, vol. 2, pp. 1, 16. 

Champlin (A. P.): The fever at Biloxi, Miss., during the summer 
and autumn of 1886. Gallard's Med. JL, N. Y,, 1887, vol. 43, p. 335. 

Grant (H. A.), Tackett (J. R.) and Folkes (H. M.) : Yellow Fever. 
Mississippi Med. Assn., Biloxi, 1898-9, vol.. 2, p. 33. 

Guiteras (G. M.) : The Epidemic in Vicksburg. Ann Rep. Sup, 
Surg.-Gen. U. S., 1906, p. 148. 

Hicks (B. J.): On the yellow fever in Vicksburg, Mississippi, in 
1847.. N. O. M. J., vol. 5, p. 220. 

Hogg (Samuel): An account cf the Epidemic Fever of Natchez, 
Mississippi, in the years 1837, 1838, and 1839. Western Journal of 
Medicine and Surgery, vol. 1, p. 401. 



MISSISSIPPI. 955 

Holt (A. C.) : Yellow fever at Woodville, Miss., and its vicinity. 
Trans. Amer. Med. Assn., 1856, vol, 9, p. 653. 

Johnston (W.): The outbreak of yellow fever at Jackson, Miss., in 
Sept., 1888. Am. Pub. Health Assn., Rep. 1888, Concord, 1899, vol. 14, 
p. 51. 

Jones (R. E.): If it was not Yellow Fever, what was it? Journal 
Miss Med. Assn., 1899, vol. 3, p. 800. 

Kilpalrick (A. R.) : An account of the Yellow Fever which prevailed 
in Woodville, Miss., in the year 1844. N. O. Med. & Surg. JL, vol. 2, 
p. 40. 

Kilpatrick (A. R.): Epidemic of Yellow Fever which scourged the 
inland town of Woodville, Miss., in 1844. Med. and Surg. Reporter, 
Phila.,J>?<vol. 40, p. 85.. 

Larmder (C. H.): Yellow fever at Natchez, Miss., Rep.. Surg.-Gen. U. 
-^Tp. H. S. M. H. Service for 1906. (Wash., 1907), p. 155. 

Lewis (P. H.) : Thoughts on the yellow fever, being a brief critical 
notice of the following recent works, viz: 1st. 'Observations on the 
epidemic yellow fever of ithe South West, by J. W. Monette, 1843;" 2d. 
"Sketches from the history of yellow fever, showing its origin; to- 
gether with facts and circumstances, disproving its domestic origin, 
and demonstration of itsc transmissibility, by W. M. Carpenter, 1844." 
N. O. M. & S. Jl., 1844-5, vol. 1, pp. 31, 44. 

Louisiana State Board of Health: Report on the Biloxi Fever. N. 
O., 1886. Reprint from N.. O. Picayune, Sept. 8, 1886, vol. 8. 

Louisiana State Board of Health: Outbreak of yellow fever at 
Biloxi, Harrison County, Miss., and its relation to interstate notifica- 
tion. N. O., 1886, vol. 8. 

Magruder (A. L. C): A history of the epidemic, which prevailed at 
Vicksburg during the Fall of 1847. N. O, M. & S. JL, vol. 4, p. 689. 

McAllister: The yellow fever of Grand Gulf, Miss., in 1853. N. O. 
M. & S. JL, 1853-4, vol. 10, p.. 675. 

McMullen (J.) : Yellow Fever in Hamburg and Roxie, Miss. U. S. 
Marine Hospital Service. Report of the Supervising Surgeon General 
for 1906, p. 167. 

Merril (A. P.) : An Essay on ithe Yellow Fever, as it appeared at 
the Bay of St. Louis in 1820. N. O. M. & S. JL, voL 8, p. 1. 

Merrill (A. P.): Ibid. In his: Med. Essays. 8°.. N. O., 1851, p. 3. 

Merrill (A. P.) : On the Epidemic of 1852 in Natchez, Mississippi. 
North American Medical & Surgical Journal, vol. 2, p. 217. 

Merrill (A. P.): On the Yellow Fever of 1823 in Natchez, Missis- 
sippi. Phila, Medical and Physical Journal, vol. 9, p. 235.. 

Monette: Observations on the Epidemic Yellow Fever of Natchez, 
and the Southwest. Louisville, 1842. 

Monette: Epidemic Yellow Fever of Washington, Mississippi, 1825. 
Western Med. and Phys, Jl. and Am. JL, vol. 1, p. 243. 



956 HISTORY OF YELLOW FEVER. 

Monette (J. W.) : The Epidemic Yellow Fever of Natchez. An essay 
read before the Jefferson College and Washington Lyceum, December 
2, 1837, 12mo. Natchez, 1838. 

Perlee (A.) : An account of the Yellow Fever at Natchez as it pre« 
vailed in the autumn of 1817 and 1819. Phila. Med. and Phys. Jl., 
vol. 1, p. 1. 

Stone (C. H.): Quarantine and Yellow Fever at Natchez in xS53, 
and 1855, etc. N. O, Med. New. and Hosp. Gaz., November, 1855. 

Ibid., Trans. Amer. Med. Assn., 1856, vol. 9, p. 643. 

Stone (C. H.): Report on the Origin of Yellow Fever in the Town 
of Woodville, Miss., in the summer of 1844. N. O. M. & S,. Jl., 1844-5, 
vol. 1, p. 520. 

Stone (C. H.): The History of the Mild Yellow Fever, which pre- 
vailed in the City of Natchez in 1848. Natchez, 1849. See also N. O. 
Med. and Surg. Jl., 1848-9, vol. 5, p. 549. 

Stone (C. H.) : The history of the mild yellow fever, which pre- 
vailed in the city of Natchez in 1848, with observations respecting its 
cha::iaoter and natural mode of cure; to which is appended, from 
various authors, descriptions and notices of that disease, of dengue, 
and of inflamation of the stomach and bowels. 8°. Vidalia, La., 1.849. 

Stone (C. H.): Report on the Origin of Yellow Fever in the Town of 
Woodville, Mississippi, in the Summer of 1844. N. O. M. & S. Jl., 
vol.. 1, 1844-5, p. 520. 

Tliornton (J. J.): Yellow Fever at Brandon, Miss., in 1853 and 1854. 
Trans. American Med. Assn., 1856, vol. 9, p. 699. 

Tcoley (Henry): History of the Yellow Fever as it appeared in the 
City of Natchez in 1823. Vol. 8, Natchez, 1823. 

(Second Edition. Washington, Mississippi. Same date.) 

Valetti (C. de) and Logan (T.) : A Report on the Yellow Fever that 
recently prevailed at Woodville (Miss.), 1844. N. O. M. & S. JL, 
1844-5, vol. 1, p. 237. 

Vansant (J.): Brief account of yellow fever at New Orleans and 
Pascagcula in 1875. Rep. Superv. Surg.-jQen. Mar., Hosp., 1874-5, 
Wash., 1876, p. 147. 

Wasdin (E.) : Inspection of the Gulf Coast between Mobile and Pass 
Christian; yellow fever in Mississippi City, Gulfport and Handsboro; 
Gulf Coast Maritime Patron. Rep. Surg.-Gen. U. S. P. H. S. M. H. 
Service for 1906. (Wash., 1907), p. 169. 

Williams: Cn the Yellow Fever at Rodney, Mississippi, in the year 
1847. N. O. M. & S. JL, 1848-9, vol. 5, p. 217. 

Williams (W. G.) and Andrews: An account of the Yellow Fever 
which prevailed at Rodney, Mississippi, during the autumn of 1843. 
N. O. M. & S. Jl., 1844-5, vol. 1, p. 35. 

Williams: Yellow Fever in Mississippi. N„ O. M. & S. JL, 1853-4,. 
vol. 10, pp. 327, 385. 



95/ 



MISSOURI. 

In the summer of 1819, j^ellow fever made its appear- 
ance simultaneously at many places throughout the 
United States. A bilious remittent fever of a malignant 
tendency became epidemic both in Missouri territory and 
in the State of Illinois. Although it generally assumed 
a milder form than on the seaboard; yet many of the 
cases reported had the characteristic features of typhus 
icterodes so decidedly marked, that the Surgeon-General 
entertained no doubt of the identity of the disease. {Army 
Med. Stats., 1819-1839, p. 8). 

There is no record as to what localities in Missouri were 
affected. 

NEW DESIGN. 

1797. Population, 200. Deaths, 57. Source of in- 
fection obscure. 

ST LOUIS. 

1854. A few cases were imported to St. Louis in 1854. 
No statistics. 

1855. August 14, an imported case. No developments. 

1878. 

Many cases of yellow fever were brought here. Among 
the first fatal cases was Capt. W. O. Nelson, of Port 
Eads, commander of the Dredge-boat at that place, and 
member of the firm, Eads & Nelson, wreckers. He died 
at St. Louis, August 13. Fatal cases among refugees con- 
tinuing, much excitement arose, and a strict quarantine 
was established. Total cases, IIG; total deaths, 46. 

The following resume by Surgeon Walter Wyman, 
United States Marine Hospital Service, and published in 
his Annual Eeport for that year, is of sufficient interest 
to be reproduced here : 

Dr. Wyman observes that the chief point of interest 
connected with the epidemic of 1878 in St. Louis, is that, 



958 HISTORY OF YELLOW FEVER. 

for the first time in th history of the city, yellow fever 
seized upon inhabitants not previously exposed in more 
southern latitudes. 

During previous epidemics, isolated cases brought 
from the South have been treated with no thought of pos- 
sible danger ; but the experience of the outbreak under dis- 
cussion, showed that former immunity from the disease 
is no guarantee of the city's future safety. There were 
at least fourteen local cases of yellow fever contracted — 
three within the city limits, five upon the quarantine 
transfer boat, and six at quarantine hospital. Ten of the 
fourteen died, and it is reasonable to suppose that had 
it not been for the efficient regulations of the Health 
Department, the scourge would have been felt far more 
severely. 

The first case occurring in St. Louis was that of a 
steamboat clerk just from New Orleans, who showed the 
first symptoms upon the 15th of July, and died upon the 
19th. Several cases of a like nature soon followed, and 
the Board of Health becoming concerned by reason of 
these deaths and the large number of refugees flocking 
to the city, determined to open the quarantine hospital 
located ten miles below, upon the western bank of the 
river. 

At first the quarantine restrictions were limited, but 
as the epidemic increased in severity, more rigid regu- 
lations were enforced. All boats were obliged to land 
and were detained for a thorough inspection. Their holds 
were disinfected with chlorine, and all sick persons re- 
moved to the hospital. Trains entering the city from the 
South were also boarded, to prevent the admission of 
yellow fever cases. Within the city limits, all refugees 
were ferreted out by the police and by health officers ap- 
pointed for that purpose, and nolens volens were taken 
by ambulance to the steamer Edioardsville — a ferry-boat 
prepared for the reception of such cases — and at once con- 
veyed to quarantine. 



MISSOURI ST. LOUIS, 



959 



BetAveen August 21, the date on which the station was 
opened, and October 22, the date of the reception of the 
last case, there were treated at quarantine 129 patients, 
88 of whom had 3'ellow fever. Of the 88 yellow fever 
cases, 42 died. 

There was nothing ]3eculiar in the character of these 
cases, unless it were a marked suppression of the urine, 
which characterized nearly all of them. The average 
period of incubation cannot be determined from the 
records of the hospital. 

Of the cases of local origin the majority were con- 
tracted or treated at quarantine, but for convenience the 
following tabulated statement of all local cases is ap- 
pended : 



Xiirse in city hospital . . . 

Steward at quarantine ... 

Nigrht watchman at Quarantine 

Engineer at quarantine . . . 

Policeman at quarantine . - . 

Resident physician at quaran- 
tine 

Cook of quarantine-boat . . 

Xurse on quarantine-boat . . 

Daughter of quarantine-stew- 
ard 

Wife of the cook of quaran- 
tine-boat 

Deck-hand on quarantine-boat 

Secone nurse on quarantine- 
boat 

Boy, George Pilcher 

Captain of quarantine-boat . 



Skizure. 



Death or other Result. 



Aug. 

Sept. 
Sept. 
Sept. 
Sept 


26. . 

13 '. '. 

20 . . 

21 . . 


Oct. 
Oct. 
Oct. 


9 . . 
9 . . 
9 . . 


Oct. 


11 . . 


Oct. 
Oct. 


13 . . 
15 . . 


Unknown 
Oct. 18 







Locality. 



Date. 



Locality. 



;City . . . . 
Quarantine 
Quarantine 
Quarantine 
Quarantine 



Quarantine . . . 
On board of boat 
On board of boat 



Aug. 31 . . I City . . . 

Recovered Quarantine 
I Recovered [Quarantine 
i Recovered Quarantine 



Quarantine 
Quarantine 
Quarantine 



Quarantine . . . 

City 

On board of boat 

On board of boat 

City 

On board of boat 



Recc 
Oct. 


)vered 

15 . . 


Oct. 


10- • 


Oct. 


19 . . 


Oct. 


16. . 


Oct. 


16 . . 


Oct. 


18 . . 


T'nk 


nown 


Oct. 


22 . . 


Oct. 


— • • 



Quarantine 



Quarantine 
Quarantine 



City . . . 
Quarantine 
City . . . 



It will be noticed in the above table that five of 
the employes of the transfer-boat Edicardsville con- 
tracted yellow fever and died; not one recovered. It 



960 HISTORY OF YELLOW FEVER. 

should, in candor, be stated, liowover, tbat the disease of 
which the boat's captain died was returned by the attend- 
ing physician as tjpho-nialarial fever, but was considered 
by others, who were probably correct, to have been yellow 
fever. 

The two fatal cases which were taken from the city and 
died at quarantine possess some interest. One was the 
vrife of the cook of the boat. This man, Nicholas Gaft, 
was taken ill on tlie 9th of October, (Wednesday), left 
the boat and visited his wife in the city. The following 
day (Thursday) he was removed to quarantine. Upon 
the following Sunday, (October 13), his wife manifested 
sypmtoms of yellow fever, was removed to quarantine, 
where she died October 16. 

The other city case, which died at quarantine, Avas re- 
moved from South St. Louis, commonly called Caron- 
delet. The resident physician pronounced it an undoubted 
case of yellow fever, stating that the patient had black 
vomit and other well-marked symptoms. 

The boy was removed by order of the health officers, 
who found him lying by the side ef a sister who had 
expired a short time previous, with apparently the same 
disease. The physicians in attendance upon the sister, 
returned as the cause of her death, a disease other 
than yellow fever, and, upon inquiry, it was found that 
some nine or ten deaths had occurred in the same gen- 
eral neighborhood, the symptoms of which closely simu- 
lated yellow fever; but the diagnosis made, had been 
typho-malarial fever, malarial hsemorrhagica, &c. 

Whether these were cases of yellow fever or not became 
a subject of warm dispute among the Carondelet physi- 
cians, the majority, however, claiming exemption of that 
portion of the city from the plague. 

One other fact concerning the local quarantine cases 
should not be omitted. When the nurse of the quarantine 
boat was first taken sick, he was placed in a convalescent 
ward, his disease being deemed simply malarial. 

Two convalescents from other diseases soon after con- 
tracted yellow fever, one of whom died. Although no 
dates have been obtained concerning these two cases they 



MISSOURI ST. LOUIS. 961 

should properly be added to the list of local cases — mak- 
ing in all sixteen. 

By reason of the vigilance of the health authorities, as 
above described, comparatively few cases of yellow fever 
were treated in the city. So far as can be ascertained 
there were about thirty-five refugee cases and sixteen 
deaths within the city limits, but it is probable that some 
cases were concealed in order to prevent a forcible trans- 
fer to quarantine. 

1879. 

Two cases, refugees from Memphis. First case, fatal 
in October; last case also terminating in death, Novem- 
ber 15. 

BIBLIOGRAPHY OF YELLOW FEVER IN MISSOURI 

Anonymous: Is it identified? A supposed germ of yellow fever 
which attached itself to a glass in New Orleans. It is not thought 
likely to return this year. [From St. Louis epRublican, May 12, 1879.] 
^t. Louis Clin. Rev., 1879-80, vol. 2, p. 103. 

Coles (W.): A Case of Yellow Fever. St. Louis Med. and Surg. Jl., 
1878, vol. 35, p. 261. 

Dorsett (W. B.) and Outley (F. T.) : [On Dr. Ford's case of urinary 
suppression in yellow fever, etc.] St. Louis Cour of Med., 1879, vol. 

1, p. 72. 

Ford (W. H.): Reports of the St. Louis Med. Soc. on Yellow Fever; 
consisting of the report of the committee appointed to inquire into 
the relations of the epidemic of 1878 to the city of St. Louis, and a 
report on the meteorological conditions and etiology of yellow fever, 
and of certain other diseases associated with a high temperature, and 
on the treatment of yellow fever. St. Louis, 1879, G. O. Rumbold & 
Co., 327 p. 3 pi. 3 tab. 2 ch. 8^. 

Ford (W. M.): A reply to the card of Doctors Dorsett and Outley. 
St. Louis Cour. of Med., 1879, vol. 1, p. 208. 

Hausnann (A.) : Observations on yellow fever. St. Louis M. & S. 
Jl., 18^9r^volv-3erpr 19.-- . 

Hill (S. D. v.): Yellow Fever. St. Louis Cour. of Med., 1879, vol. 

2, p. 326. 

Is St. Louis to have an epidemic of Yellow Fever? [Edit.] St. 
Louis Cour. of Med., 1879, vol. 1, p. 400. 

Wyman (W.): Notes upon yellow fever epidemic of 1878 in St. 
Louis and at St. Louis quarantine. Rep. Superv. Surg.-Gen. Mar. 
Hosp., Wash., 1878-9, p. 143. 



962 

NEW HAMPSHIRE. 

POETSMOUTH. 

1793. Infected by a ship from Martinique. Limited 
outbreak. 

1796. First case, August; last case, October. The 
deaths were about 100. The prevalence of epidemic 
dysentery at the same time as the fever, served to greatly 
swell the mortality. 

1802. Sporadic cases ; deaths, 10. 

BIBLIOGRAPHY OF YELLOW FEVER IN NEW HAMPSHIRE. 

Berenger-Feraud: Fievre Jaune, etc., Paris, 1890, p. 8. 
Keating: History of Yellow Fever, p. '81. 
• New .York Medical Repository, 1799, -vol. 2, p. 211. 



963 

NEW JERSEY. 

BKIGHTON. 

1798. Limited outbreak. No statistics. 

BURLINGTON. 

1798. Limited outbreaks. No statistics. 

CAMDEN. 

1853. Infected by Philadelphia. No complete stat- 
istics. 

GLOUCESTER. 

1805. Source of infection obscure. Outbreaks was not 
general. 

1870. A few cases, refugees from New York and Goy- 
ernor's Island. No accurate statistics. 

JERSEY CITY. 

1878. One case, Septepiber 16, a refugee, terminating 
in death on the 20th. 

PERTH AMBOY. 

1811. Deaths, 5. 

PORT ELIZABETH. 

1798. Infected by Philadelphia. First case, August 
9 ; last case in September. Cases, 13 ; deaths, 6. 

WOODBURY. 

1798. Probably infected by Philadelphia. No record. 
1853. One case, a refugee from Philadelphia. Re- 
coTery. 



934 HISTORY OE YELLOW EEYER. 

BIBLIOGRAPHY OF YELLOW FEVER IN NEW JERSEY. 

Gotham: N. Y. Med. Repository, 1856, p. 564. 

Griscom: Visitations of Yellow Fever, u. 9. 

History of the Yellow Fever which prevailed at Perth Amboy, New 
Jersey, in the Summer of 1811, and of the Evidences of its Importation 
into that place. Medical and Philos. Register, vol. 3, p. 94. 

Keating: History of Yellow Fever, p. 80. 

Report of the Board of Health of New York on the Yellow Fever 
at Perth Amboy in 1811, by Drs. Hosack, Bayley, and Douglass. 
Medical and Philosophical Register, vol 3, p. 95. Edinburgh Medical 
and Surgical Journal, vol. 8, p. 165. 

Lee: N. Y. Med. Repository, 1800, vol. 3, p. 246. 

Report Sup. Surg.-Gen. U. S. A., 1873, p. 87. 

Report Board of Experts, 1878. 

Transactions College of Physicians, Phila., 1853. 



965 

NEW YORK. 

ALBANY. 

1746. First case in August. Deaths, 45. 
1798. No statistics. 

BAY RIDGE. 

1856. Infected by Brooklyn. Only a few cases resulted. 

BROOKLYN. 

1809. First case in July; last case in September. 
Deaths, 40. Infected by ship Concord^ from Havana. 

1823. No statistics. ^ 

1856. Infected by Goyernor's Island. First case, July 
14. Cases, 29. 

1878. At Nayy Yard. First case, July 12; last case, 
July 18. Cases, 8; deaths, 3. , 

1879. Population, 565,000. Deaths, 11; all refugees 
from infected places. 

1888. Population, 805,855. Infected by Spanish bark 
Maria Louisa from Havana and steamship' Ceareuse from 
Pernambuco. 

CATSKILL. 

1743; 1794. Sporadic cases. 

1803. First case, August 10; last case, September 23. 
Deaths, 8. 

1804. No statistics. 

GREENFIELD. 

1798. Sporadic cases. 

GOVERNOR'S ISLAND. 

1856. Infected by shipping. On July 26, the nrst case 
of yellow fever occurred in a resident of Rotten Row — 
she died with black vomit, August 2. On August 1, three 



^66 HISTORY OF YELLOW FEVER. 

other cases occurred, one in Eotten Eow and two from 
South Battery; and in these two places the disease fixed 
its abode, as it were, almost exclusiyelT, and continued 
until the number of cases amounted to sixty-three, fifteen 
of whom died, 1 in 4,2. Very few cases occurred on other 
parts of the Island, besides South Battery and Eotten 
Eow, and those that did thus occur were in almost eyery 
instance (probably all) in persons who were in the 
habit of visiting Eotten Eow. 

In South Battery the disease continued its ravages un- 
til early in September, when the occupants were removed 
to quarters in another iDortion of the Island, only two 
cases occurring among them after their removal. In 
Eotten Eow it lingered until checked by cool weather on 
the 9th of October. 

Cases, 159; deaths, 52. 

1870. Population, 771. First case, August 13; first 
death, August 20 ; last case, October 2Q ; last death, Octo- 
ber 29. Cases, 159; deaths, 52. 

GOWANUS. 

1S5G. Infected by shipping. Sporadic cases. 

HUXTIXGTOX. 

1795; 1798. Limited outbreaks. No authentic stat- 
istics. 

LOCKPOET. 

1878. One fatal case, a refugee from Memphis, Sep- 
tember 29. 

MO:XTAUK POINT. 

1898. Cases, 4; deaths, 0. 

NEW YOEK. 

1668. First appearance of yellow fever in the United 
States. No complete statistics. 

Yellow fever raged severely in New York, to such a 
degree that scarcely a patient survived it; and, by some 



NEW YORK CITY. 967 

accounts, it was more fatal than any disease since that 
period. It was popularly known as ''the great sickness.'' 
One account states that several hundred died up to Sep- 
tember, and 70 more during the succeeding week, in a 
population of only 6,000 or 7,000. On account of the 
pestilence, the Assembly was held at Jamaica, Long 
Island. The disease was said to haye been imported from 
St. Thomas. 

Last death, September 30. Deaths, 370, 

1719. ''In the year 1719, there were a few cases of yel- 
low fever near the Old Slip ; but by the vigorous exertions 
of the Board of Health and the blessing of Divine Provi- 
dence, it was suppressed before it had attained an alarm- 
ing height." (Hardie, p. 22). 

1743. Deaths, 217. 

1745; 1747; 1748; 1763. Yellow fever years. No 
statistics. 

1789. Deaths, 76. 

1791. First case, August — ; last case, October 15. 
"General Malcolm and some other very respectable citi- 
zens fell victims to its fury." (Hardie, p. 1). 

1792; 1793; 1794. Yellow fever years. No statistics. 

1795. First case, July 19. Deaths, 732. 

1796 ; 1797. No statistics. 

1798. Great epidemic. Deaths, 2,086. 

(From 1799 to date, unless otherwise noted, the figures 
given in this resume represent occurrences at the Quar- 
antine Hospital). 

1799. First case, July — ; last case, November. Cases. 
163; deaths, 74. 

1800. First case, September -^; last case, October 14. 
Cases, 38 ; deaths, 21. 

1801. First case, September — ; last case, October — • 
Cases, 35 ; deaths, 16. 

1802. Cases, 5 ; deaths, 2. 

1803. First case, July 18 ; last case, October 29. Cases, 
1,639 ; deaths, 606. 

Epidemic in the city. 

1804. Cases, 8; deaths, 5. 



!)68 HISTORY OF YELLOW FEVER. 

1805. First case June — ; last case, October — . Cases, 
43; deaths, 25. In the city proper there were 600 cases, 
of which 262 died. 

1806. First case, June; last case, November. Cases, 
2; deaths, 0. 

1807. Cases, 3 ; deaths, 3. 

1808. Cases, 1; deaths, 1. 

1809. Cases, 2; deaths, 2. 

1810. Cases, 1; deaths, 1. 

1815. Cases, 19 ; deaths, 7. 

1816. Cases, 2 ; deaths, 0. 

1817. Cases, 5; deaths, 4. 

1818. Cases, 7; deaths, 4. 

1819. First case, August. Cases, 26; deaths, 19. 

1820. Cases, 2; deaths, 2. 

1821. Cases, 28: deaths, 16. 

1822. 

'At the Marine Hospital the first case erupted July 10 
and the last November 6. Cases, 43; deaths, 25. 

The city was infected by the Marine Hospital and ex- 
perienced a limited epidemic. The first cases were dis- 
covered July 17, at No. 26 Kector Street. By September, 
the disease was widespread. On the 28th of that month, 
the following remarkable document was presented to 
the common council and ordered promulgated : 

"To the Honourable ithe Mayor, Aldermen and Commonalty of the 
city of New-York: 

The memorial of the undersigned clergymen of different denomina- 
tions of this city, respectfully suggests to your honourable body, that 
acknowledging as we do the being and Providence of the "only Lord 
God our Lord Jesus Christ," and confessing as we must, a common 
criminality and demerit in his sight, and visited as we are with one of 
those desolating scourges, which himself expressly challenges in his 
word, not only as a judgment, of which he is the righteous disposer; 
but as one of his "sore judgments," upon a community of transgres- 
sors, and knowing as we may, that his own invisible agency appoints 
and controls, in sovereign wisdom, all the series of secondary causes, 



NEW YORK CITY. 969 

however, complex and inscrutible to man, it becomes us, every way in 
our collective character as a city, and after the example of ancient 
Nineveh to humble ourselves under the mighty hand cf God, that 
he may exalt us in due time.. 

The reasons and propriety of such a general humiliation before God, 
are sufficiently obvious, we fondly hope, to your honourable body. 

Having thus suggested to your Honorable Body a measure which 
we confide to your wisdom to approve, because it seemed, all things 
considered, to be expedient and incumbent; a measure, which seems 
to be demanded, not more by our present circumstances and the 
aspect of Divine Providence, than by the common consent of the wise 
and the good and praying, that "the wisdom that is from above," 
may enlighten all your deliberations and bless your administration, 
we subscribe ourselves, honourable Sirs, your friends and fellow 
citizens. 

J. B. Romeyn R. M'Cartee 

E. Washburn James G. Ogilvie 

N. Bangs S. Martindale 

Alexander M'Leod Isaac Chase 

H. Peneveyre William Gray 

S. N. Rowan Samuel H. Cox 

Samuel Nott, Jun. Ward Stafford 

Nich. S. Marselus Peter Ludlow, Jun. 

The disease was not very widespread, for there were only 
401 cases, of which 230 died. 

1823. Cases, 8 ; deaths, 5. 

1824. Cases, 28; deaths, 8. 

1825. Cases, 2; deaths, 1. 

1826. Cases, 2 ; deaths, 2. 

1827. Cases, 6; deaths, 4. 

1828. Cases, 1; deaths, 0. 

1829. Cases, 4; deaths, 0. 

1830. Cases, 2; deaths, 1. 

1831. Deaths, 1. 

1832. Cases, 1 ; deaths, 1. 

1833. Cases, 12; deaths, 2. 

1834. Cases, 3; deaths, 1. 

1835. Cases, 2; deaths, 2. 

1838. Cases, 26 ; deaths, 8. ^ . - 

1839. Cases, 4; deaths, 4. 



970 HISTORY OF YELLOW FEVER, 

1843. Cases, 18; deaths, 3. 

1811. First case, Aiionst 12. Cases, 9; deaths, 2. 

1816. Cases, 2; deaths, 0. 

1817. Cases, 1; deaths, 0. 

1818. Cases, 2{) ; deaths, 12. 

1852. Cases, 1; deaths, 0. 

1853. Cases, 11; deaths, 15. 
1851. Cases, 45; deaths, 20. 
1855. Cases, 12; deaths, 5. 

1856. 

After a lapse of thirtv-fotir rears (1822 to 1856) yellow 
fever again made its a^Dpearance in Xew York. Between 
these years, many eases were brotight by vessels from the 
Spanish Main, btit they were all treated at the Marine Hos- 
pital, and in no instance was the infection carried ashore. 
In 1856, however, the population of the metropolis 
of the world had a narrow escape from the cltitches of 
the Yellow Demon. 

The circumstances were as follows : 

One case of yellow fever was received from Havana m 
the month of April; but no other cases were seen until 
June 18, when the bark Julia J/. HaJlocl'. from Santiago 
de Cuba, arrived, with captain, first mate, and a pas- 
senger sick with the fever. On the 21st of the same 
month, the ship Jane H. Gliddon, from Havana, arrived, 
having a passenger and four seamen dangerously ill with 
the disease; and from the same vessel three other cases 
were subsequently received. These were all of a strongly, 
marked character; and some of them occurring many 
days after the ship's arrival, an infected condition of the 
vessel was nattirally inferred, and the spread of the in- 
fection anticipated. From this ship the infection did 
spread, until at least twenty of the stevedores and lighter- 
men who were engaged in tmlcading her, contracted the 
disease. 

In the Annual Report of the Fhijsielan in Chief of the 
'Marine Hospital at Quarantine for 1856, ptiblished at 
Albany in 1857, is presented a chronological summary of 



NEW YORK CITY. 971 

all the cases of yellow fever that occurred during this 
remarkable outbreak. A record of 538 cases is given, of 
which more than one-third died. 

• 1870. 

In 1870, New York again found the spectre of yellow 
fever at her doors, and only escaped an invasion of the 
disease through the inactivities of the Stegomijia Calopus^ 
who confined their operations to a circumscribed area. 

The following resume is made from the account given 
by Dr. Moreau Morris, City Sanitary Inspector,' in the 
Annual Report of the Neic York Board of Health for 
1870 : 

On September 13, 1870, information reached the Bureau 
of Sanitary Inspection that a Mrs. Kelly was lying dead 
at No. 14 Essex Street, New York. She had been sick for 
about a week, ''with a fever, which did not present the 
types of the ordinary fevers usually found in the city." 
An immediate investigation of the history and circum- 
stances attending this case, aroused the suspicion that it 
might have been yellow fever. The body was, therefore, 
sent to the morgue at once for a specific investigation. 
The bed was burned, and the rooms and clothing thor- 
oughly fumigated and disinfected. 

It Avas ascertained that her husband, James Kelly, had 
been sick also with the same symptoms, and had been 
removed to Bellevue Hospital, v^^here he had died upon 
the same day (the 12th) as his wife. 

A post-mortem examination was held upon the body 
of James Kelly, on the 13th of September, by the curator 
cf Bellevue Medical College, which, it was presumed, 
would reveal the true character of the disease. 

The hospital record, as made at the time of the inves- 
tigation, is as follows : 

'''James Kelly, admitted September 12, 1870: his- 
tory, obscure: comatose when admitted; skin, jaundiced; 
respiration, 30 ; pulse, 116 ; temperature, 98 1/2 deg. F. ; 
hepatic tenderness; tongue, dry and coated; died, Sep- 
tember 12, 3 :30 p. m. 



972 HISTORY OF YELLOW FEVFR. 

"Autopsy, September 13. Brain and membranes, nor- 
mal ; larynx, normal ; oesophagus, mucous membrane 
eroded in longitudinal patches." This case received a cor- 
oner's investigation, and the verdict of the jurors was 
"Death by exhaustion." The medical certificate attached 
to the coroner's return, certifies that the cause of his 
death was "Coma (cause unknown)." 

Signed by 

JOHN J. REID, M.D., 
Medical Attendant at Inquest. 
No post-mortem examination of the body of Mrs. Kelly 
was held, but the certificate of death is recorded as 
follows : 

Coroner's verdict — "Pernicious fever." 
Medical certificate — "Is supposed to be either yellow 
fever or tvphus fever." 

(Signed) WOOSTER BEACH, 

Medical Attendant at Inquest. 

The records of the examination unfortunately were so 
meagre, as to afford no clue to the disease, and the doubt 
still existed as to its true character, until subsequent cases 
and further investigation pronounced the diagnosis. 

In tracing the source of their illness, it was subse- 
quently discovered that both Mr. and Mrs. Kelly had been 
visiting and attending the "wake" and funeral of a rela- 
tive on Governor's Island, on the 2nd and 3rd days of 
September, remaining thereon over night. 

This relative, Wm. Harrington, was a soldier upon the 
Island, who died on the 1st of September, of what was 
stated at the time as "typho-malarial or bilious fever." 

It was also ascertained that a Mrs. Ann McCormack, 
another relative who had attended the same "wake" and 
funeral, had subsequently sickened and died on the 9th 
of September, at 49 Oliver Street. The cause of her 
death was certified by the attending physician as "typhus 
fever." By careful inquiries, it was found that these 
three cases presented almost identical syniTDtcms. Their 
similarity and obscurity indicated a coincident exposure 
to the same exciting cause, and incited still further in- 



NEW YORK CITY. 97S 

quiry. This resulted (after a delay of four days, caused 
by false information) in the discovery, as before stated, 
of their presence at the funeral of Wm. Harrington, on 
Governor's Island. 

Attention being now directed to that island as the 
source, a Health Inspector, with another medical officer 
who had been familiar with diseases of tropical climates, 
was directed to visit it and report upon its character. It 
was found that a disease of similar character had been 
prevailing there since the 13th of August (over a month), 
and which the surgeons in attendance described as a 
type of malarial fever, accompanied with more than usual 
fatal results. Many of the residents had suffered, some 
with a very mild attack, readily yielding to treatment, 
while others, seized in a more violent form, had suc- 
cumbed. No suspicion of yellow fever had been enter- 
tained by the attending surgeons of the post, neither 
could they become satisfied of the fact until the pathog- 
nomonic symptom of ^^black vomit" subsequently appeared 
as the disease progressed. 

The report of the two officers, after visiting the cases 
upon the Island, was that the type of disease was that 
of the "pernicious remittent fever so frequently seen in 
the South, and which so generally precedes yellow fever 
in that locality." 

The surgeons of the post had made post-mortem exami- 
nations of the dead, and had carefully watched with the 
microscope for casts or other evidences of yellow fever; 
no case had presented "black vomit," and, therefore, no 
correct diagnosis had been made. 

The suspicions which had been entertained by the med- 
ical officers of the Board of its being yellow fever, were 
thus, in a measure, quieted, as no positive evidence had 
yet presented itself. 

About this time other cases presenting the same doubt- 
ful symptoms occurring in New York City had come to 
the knowledge of the Board, all of which were traced to 
Governor's Island as their source; and a fresh, or rather 
increased outbreak, with more marked symptoms, having 
occurred upon the Island, the Board, anxious to settle, if 



974 HISTORY OF YELLOW FEVER. 

possible, the doubt requested Dr. J. C. Nott, of Mobile, 
a gentleman wlio had large experience in this special dis- 
ease in Southern States, to visit the Island and report 
his opinion. On the 2nd of September he visited the 
Island, and the diagnosis was made clear by a post- 
mortem examination of a recent case of this disease and 
the presence of ^'black vomit" in others. His report to 
the Board on the following day, was that it was undoubt- 
edly yellow fever. A special committee v\^as immediately 
appointed by the Board, consisting of the Chairman of 
the Sanitary Committee, Dr. G. Ceccarini, the Health 
Officer of the Port, Dr. John M. Carnochan, and the City 
Sanitary Inspector, Dr. Moreau Morris, and it was au- 
thorized to take the .necessary measures for the removal 
to quarantine of; those sick with 3^ellow fever at Gov- 
ernor's Island, and to protect this city from said disease; 
and it was further instructed to investigate the origin of 
the disease and the circumstances of its introduction at 
Governor's Island. 

The Committee, upon the same day, visited the Island, 
and becoming satisfied of the true nature, of the disease, 
so reported to the Board, and at once conferred with the 
Commandant of the Post, General Neil, with reference to 
removing those sick, and placing the Island under quar- 
antine restrictions, etc., etc. It was referred directly to 
General McDowell, commanding the Department lOf the 
East, by whose order alone such measures could he af- 
fected. The same night, in consultation with General 
Cuyler, Medical Director of the same department. General 
McDowell promptly issued the necessary orders, as had 
been suggested by the Committee. The following two 
days were devoted actively to procuring the means of 
making the transfer of patients, which was accomplished 
on the morning of October 1. Sixty patients, including 
many who were in a convalescent stage, were then 
removed. 

Other cases continued to present themselves and it was 
not until the 26th of October that the last case appeared. 



New YORK CITY. 975 

The records of the cases occurring upon Goyernor's 
Island will be found in the history of the preyalence ol: 
yellow fcA^er at that place in the preceding pages. 

From time to time the following cases were discoyered 
in NcAy York City, during the period of its preyalence 
upon the Island. Each case was closely watched by the 
medical officers of the Board, and without an exception 
all were ascertained to haye yisited the Island either as 
nurses or friends of the sick, or were soldiers on leaye 
of, absence, taken sick at their homes. The record is as 
follows: 

1. Ann McCormack, 49 Oliyer Street, died Septembei* 

9, 1870. 

2. James Kelly, 14 Essex Street, died September 12, 

1870. " ■ ,.,., 

3. Mrs. Kelly (T^'ife of aboye), 14 Essex Street, 

died September 12, 1870. 
4J ' Dayid Straney, 12 Pell Street, died September 15, 

■;.'. ^■..'"1870. 

5. 'Urs. Mertens, 89 Clinton Street, died September 25, 

^ 1870r'"' . 

6. Peter Becker, 125 Clinton Street, died October 1, 

1870. 

7. Eliza Mertens, 89 Clinton' Street, died October 2, 

1870. • .:/ : 

8. Eliza Stelche, from GoyeriiOr's Island, at Belleyue 

Hospital, died October 4, 1870. 

9. William H. Morris, 117 West Twenty-first Street, 

died'October 9, 1870. 

10. Charles Haab, 126 East Fourth Street, a soldier 

on leaye, taken sick September 19, recoyered. 

11. John Haffffe'r,' 405 West Forty-first Street, a soldier 

on leaye, taken sick September 25, recoyered. 

There is no eyidence of any other case haying occurred 
in the city. 

With reference to these cases, it was ascertained beyond 
all question as follows : 

The first four were persons who yisited Goyernor's 
Island and attended the funeral of Wm. Harrington, who 
died on the 1st of September and was buried on the 3rd ; 



976 HISTORY OF YELLOW FEVER. 

the fifth, sixth and seventh cases were immediate relatives 
of Sergeant Merten's, who was sick upon the Island, and 
whom they visited and attended upon as nurses — No. 5 
being the mother, No. 6 the brother-in-law and No. 7 the 
sister. 

The eighth case was a soldier's wife residing upon the 
Island, who was removed therefrom surreptitiously, for 
fear of being taken to Quarantine Hospital, and taken to 
Bellevue Hospital, where she died; the disease being un- 
recognized until after death by the medical attendants. 
Case nine was a discharged soldier from the Island, sick 
when he left, ill two weeks before death at his father's 
house. Cases 10 and 11 were soldiers, at home, on leave 
of absence, taken sick while at home, and remaining there; 
finally recovered. 

These eleven cases, scattered in different portions of 
the city, it was feared, might prove centers for infection, 
and were watched with great care. In each case all the 
measures of disinfection and sanitary care were applied, 
which would, if possible, prevent its further spread. 

In no instance did any person suffer from its effects, 
or from the diffusion of any poison therefrom, beyond the 
case itself, within the city. 

1872. No statistics. On vessels in harbor. 

1873. First case. May 23 ; first death, August 1 ; last 
case, October 1; last death, September 27. Cases, 62; 
deaths, 13. 

In the city proper, three fatal cases, all refugees from 
New Orleans. 

1875. On vessel in harbor. 

1876. Cases, 2; deaths, 2. Kefugees from Savannah. 

1878. 

Population, 1,235,389. 

Yellow fever appeared August 16th. Patrick Wm. 
Riley, a horse-shoer from New Orleans, arriving: that day, 
very sick, was sent to quarantine and soon died. Wil- 
liam Schultz died August 22 ; a week later, Mrs. Joseph 
Cellers, a Memphis refugee, living in Tenion Court, a 



NEW YORK CITY. 9? 7 

narrow lane near 53 University Place, Avas taken with 
fever jnst after giving birth to a child; she was sent to 
quarantine, and died September 30. Dr. N. A. Lindley, 
Avho felt the s^'mptoms of yellow fever on his Avay from 
Memphis, arrived at quarantine September 23, and died 
there. He Avas one of the many heroes of the terrible 
epidemic of 1878, being among the first to respond to the 
call for aid when the fever, broke out in Memphis. Worn 
out with incessant work, he sought to return to his family, 
who were in the North. Yfhen he reached New York, he 
proceeded at once to the quarantine hospital, and gave 
Dr. Vanderpoel an account of his case. He received every 
attention; Dr. Vanderpoel visiting him three times a 
day. He rallied on Friday night, but sank rapidly soon 
after, and died at noon September 30. 

Total deaths, 4 — all refugees. The disease did not 
spread to the inhabitants. 

1879. First case, June. 

1880. Fourteen cases, of which five proved fatal, from 
vessels in harbor. 

1881. Population, 1,206,517. Deaths, 1. 

1887. First case, September 7. Cases, 1. 

1888. Population, 1,535,538. One case, a refugee from 
Oak Lawn, Fla., on September 10; death, September 12. 

1888. Infected by Port au Prince, Hayti. First case, 
November 24. 

1889. Cases from various vessels arriving from in- 
fected ports. First case, June 10; first deaili, September 
15. Cases, 5 ; deaths, 2. 



1890. 


Cases, 1. 


1893. 


Cases, 1; deaths, 1. 


1895. 


No statistics. 


1896. 


Cases, 1; deaths, 1. 


1897. 


Cases from- vessels in harbor. 


1898. 


Cases, 1; deaths, 1. 


1901. 


Cases, 3. 


1905. 


Deaths, 1. 




QUEENSBOKOUGH. 


1801. 


Scattered cases. 



978 HISTORY or YKLLOW FEVER. 

EED HOOK. 
1856. Scattered cases. 

EONDOUT. 
1843. Scattered cases. 

STAPLETON. 

1848. First case, August 23. 

STATEN ISLAND. 

1848. Scattered cases. 

TOMPKINVILLE. 

1848. Scattered cases. 

WALLABOUT. 

1804. Scattered cases. Infected by vessels from Cajie 
Haytien, Hayti, and Guadeloupe. 

WEST KECK. 
1795. Scattered cases. 

WEST POINT. 
1804. No statistics. 

YELLOW HOOK. 

1856. Infected by Governor's Island. No statistics. 



NEW YORK. 979 

BIBLIOGRAPHY OF YELLOW FEVER IN NEW YORK. 

Accurate (An) list of persons who have died of malignant fever in 
this city, including those of Bellevae, etc., from July 29 to October 29, 
with the date of their deaths; al30 of the different places where 
the deaths occurred, and the number that died in each street; taken 
from the reports of the health committee. 18°. New York, 1803. 

Allen (S.): Letter of the Hon, , mayor of the city of New 

York, to Joseph Bayley, health officer of the port, in relation to the 
cases of yellow fever at the quarantine ground in 1821, and Dr. 
Bayley's report thereon. 8°. New York, 1822. 

Bayley (Joseph) : Facts and Observations relating to the Yellow 
Fever which prevailed at the Quarantine Establishment at Staten 
Island, New York, during the autumn of 1821. New York Medical 
and Physical Journal, vol. 1, p. 12. 

Bagley (Jos.): Report on the Cases of Yellow Fever at the Quaran- 
tine Ground of New York in 1821. New York, 1822. 

Bagley (Jo3.) : Report on the Yellow Fever which prevailed in New 
York in 1822, in a Letter addressed to his Honor the M^yor. New 
York Medical and Physical Journal, vol. 1, p. 422. 

Bayley (R.) : An Account cf the Epidemic Fever which prevailed in 
the city of New York during part of the summer and fall of 1795. 8vo. 
New York, 1796. 

Bayley (R.) : Letters from the health office, submitted to the com- 
mon council of the city of New York. 8°. (New York, 1799.) 

Beck: Review of Townsend on Fever of New York in 1822. New 
York Medical and Physical Journal, vol. 2, p. 473. 

Golden (Cadwallader) : Remarks on the Yellow Fever of New York 
in 1741 and 1742. (Written in 1743.) New York Medical Repository, 
vol. 14, pp. 1, 159. 

Davis (M. S.) : A brief Account of the Epidemic Fever which lately 
prevailed in the city of New York. New York, 1795. 

Documents relating to the Board of Health, New York: 1, Address 
to the Public. 2. City Inspector's Report. 3. Letter from the Health 
Officer (Dr. J. R. B. Rogers) to the Board of Health. 4. Letter of Dr. 
E. Miller to the Governor, January, 1804. 5.. Dr. Miller's Report of 
the Fever of 1805. New York, 1806. 

Drake (C.) : An account of the Endemic Yellow Fever, as it occurred 
in the city of New York during the summer and autumn of 1819. New 
York Medical Repository, vol 21, p. 125. 

Dwight (F. M.): Report of the case of yellow fever in New York. 
Med. Rec. N. Y., 1884, vol. 26, p. 264„ 

Dwight (B. W.) : Some Remarks on the Origin and Progress of the 
Malignant Yellow Fever as it appeared in the village of Catskill, State 



980 HISTORY OF YEL.OW FFVER. 

of New York, during the summer and autumn of 1863. Medical Re- 
pository, vol. .8, pp. 105-232. 

Forry: Account of a Malignant Fever whicii prevailed at Rondout, 
Ulster County, New York, in the months of August and September, 
1843, with an inquiry into its nature, and into the question of its im- 
portation by the schooner Vanda, etc. New York Journal of Medicine, 
l3t series, vol. 1, p. 293. 

■Gillespie: Arswer to Dr. RogeiG' Strictures on his Report on the 
Fever of Brooklyn in 1809,. Medical and Philosophical Register, vol. 
1, p. 269. 

Gillespie: Report on the Yellow Fever which prevailed at Brooklyn 
in the summer of 1809. Medical and Philosophical Register, vol. 1, 
p. 101. 

GriiLCcoi (J. H.): A History. Chronological and Circumstantial of 
the Visiiaticns of Yellow Fever at New York. Octavo. N. Y. (No 
date.) 

Hardie: An Account of the Yellow Fever which occurred in the 
City of New York in the year 1822. 12mo. New York, 1822. 

Hardie (James) : An Account of the Malignant Fever lately pre- 
valent in the City of New York, 1798, 8vo. New York, 1799. 
• Health Laws of New York: 1798, 1805, 1823. 

History of the Proceedings of the Board of Health of the City of 
New York in the Summer and Fall of 1822, and an Account of the 
Yellow Fever of that Season. 8vo. New York, 1823. 

Hosack (A.) : An inaugral essay on the yellow fever, as it appeared 
in this city in 1795. 8°. New York, 1797. 

Hosack (Alexander) : Plistory of the Yellow Fever " as it appeared 
in the city of New York in 1795. 8vo. New York, 1797. 

Laws of New concerning Infectious Diseases. 8vo. 1798. 

McKnight (Rev. John) : Account of the Origin of the Yellow Fever 
which prevailed in the City cf New York in the Summer of 1798, in a 
Letter to Dr. Hosack. Iv^edical and Philosophical Register, vol,. 3, 
p. 293. 

Miller: Report on the Malignant Disease which prevailed in the City 
of New York in the Autumn cf 1805, addressed to the Governor of the 
State of New York. Collected works, p. 87. . 

Pascalis: Statement of Occurrences in the City of New York during 
an Epidemic of Yellow Fever in 1819. See Medical Repository, vol. 
20, p. 229. (N. S., vol. 5, No. 3.) 

Pestilence: Account of the Yellow Fever of New York in 1805. 
Medical Repository, vol, 9, p. 211. 

Ramsay (Alex.) : Observations on the Yellow Fever of New York in 
1803. Edinburgh Medical and Surgical Journal, vol. 8, p. 422. 



NEW YORK. 981 

Remarks on the Report of the Medical Society on the Fever in 
Bancker Street. 8vo. New York, 1820. 

Report of the Board of Health of New York, 1806, p. 19. 8vo. 

Report of the Committee appointed by the Medical Society of the 
State of New York, to inquire into tlie Symptoms, Origin, Cause, and 
Prevention of the Pestilential Disease. 8vo. New York, 1799. 

Report of the Committee of the Medical Society of the city and 
country of New York, on the Causes and Character of the Epidemic 
Fever which prevailed in Eancker Street and its vicinity, in the sum- 
mer and autumn of 1820. New York, 1820. 

Rogers (John R. B. ): A Letter on the Yellow Fever of Brooklyn in 
1809, and Proofs of its Non-importation there. New York Medical 
Repository, vol. 13, p. 198. 

Rogers: Remarks on Dr. Gillespie's Report en the Yellow Fever of 
Brooklyn in 1811. American Medical and Philosophical Register, vol. 
1, p. 253. 

Seaman (V.): An Account of tl:e Epidemic Disease which appeared 
at New York in the Summer and Autumn of 1800. Medical Repository, 
vol. 4, p. 248. 

Seaman: An Inquiry :nto the Cause of Prevalence of Yellow Fever 
in New York. Medical Repository, vol. 1, p. 315. 

Seaman: An Account of the Epidemic Yellow Fever, as it appeared 
in the City of New York in the year 1795. Webster's Collection, p. 1. 

Smith (E. H.): Letters to William Buel, on the Fever which pre- 
vailed in New York in 1795. Webster's Collection. 

• State (A) of Facts relative to the late Fever which appeared in 
Bancker Street and its Vicinity. Published by order of the Board of 
Health. New York, 1821. 

Townsend: An Account of the Yellow Fever as it prevailed in the 
City of New York in the Summer and Autumn of 1822. 8vo. New 
York, 1823. 

Vache (Alex. J.): Letters on Yellow Fever, Cholera, and Quarantine, 
addressed to the Legislature of the State of New York; with additions 
and notes. 8vo. New York, 1852. 

Watters (Daniel D.) : Diary of the Occurrences of the first month of 
the Yellow Fever which prevailed in the City of New York in 1822. 
New York Medical and Physical Journal, vol. 1, p. 469. 

Yates: Observations on the Yellow Fever of New York in 1822. 
Medical Repository, vol. 23, p. 1. 

Yates (Christ. C): Review of an essay on the Bilious Epidemic 
Fever prevailing in the State of New York. 8vo. Albany, 1813. 



98i 

NORTH CAROLINA. 

BEAUFOET. 

1854. Xo accurate statistics. 

1864. Icfected hj Xcvrberno, X. C. First case, Sep- 
tember 21; last case, Xoyember IT. Deaths, QS. 
1871. Xo statistics. 

GOLDSBORO. 

1888. One case, a refugee from Florida ; recovery. 

HATTEKAS. 
18G1. Infected by Xewberne. Xo statistics. 

MOORHEAD CITY. 
1864. Infected by Xewberne. Xo statistics. 
XEWBERXE. 

1799. Xo statistics. 

1864. Population, 9,000. First case, September; t;ist 
case, Xovember. Deaths, 700. 

ROAXOKE ISLAXD. 

1864. Infected by Xewberne. 

SMITHVILLE. 

1862. Xo statistics. 

WASHIXGTOX. 

1800. Xo statistics. 



NORTH CAROLINA. 983 

WILMINGTON. 

1796 ; 1800 ; 1821. Yellow fever years. No statistics. 
1862. Infected bj Nassau, Bahama Islands. First 
case, August 6; last case, November IT. Deaths, 446. 

BIBLIOGRAPHY OF YELLOW FEVER IN NORTH CAROLINA. 

Berenger-Feraud: Fievre Jaune, etc., Paris, 1890, p. G5. 

Brown: Quarantine, p. 18. 

Choppin: Trans. Am. Pub. Health Assn., 1877-8, vol. 4, p. 195. 

Griscom: N. Y. Jl. of Med., 1856, p. 369. 

Hand: Trans. Am. Pub. Health Assn., 1877-8, vol. 4, p. 293. 

Hill (John) : Some Observations on the Yellow Fever, as it pre- 
vailed in Wilmington, North Carolina, in the Autumn of 1821. Am. 
Med. Recorder, 1822, vol. 5, p. 86. 

N. Y. Med. Repository, 1808, p. 197. 

Ibid., 1800, p. 187. 

Report Med. Inspector U. S. Army, December 31, 1864. 

Rep. Sup. Surg.-Gen., 1873, p. 89. 

Rosset (De) : An Account of the Pestilential Fever which prevailed 
at Wilmington, North Carolina, in 1796. Medical Repository, vol. 2, 
p. 153. 

V. S. Pub. Health Reports, 1881, p.. 180.. 

Wragg: N. Y. Med. JL, 1869, pp. 225, 478. 



Q84 



OHIO. 

CALEDONIA. 

1878. One case, a refugee. 

CINCINNATI. 

1871; 1873. Cases among refugees. 

1878. Population, 280,000. The first case was a young 
lady liying in a house where baggage from New Orleans 
Avas stored, and the second case occurred in the same 
locality. Harris Hackett and Blanche Offner died August 
28. A Jewish refugee died on Walnut Hills. The family 
fled, the alarmed nurse left the body, and no one would 
enter the house to bury the corpse, until Police Officer 
Joe Smith bravely led the way. 

Total cases, all refugees, 49; total deaths, 19. Date of 
last death, October 31st. 

1879. Eefugee from Memphis. No cases among in- 
habitants. 

' 1897. One case, a refugee. 
1905. Three cases — all refugees. 

DAYTON. 

1878. Population, 38,374. Yellow fever was brought 
here in September by some refugees from Key West and 
other infected places. Among the fatal cases was Joseph 
Lebolt, from Holly Springs, Miss. He was attended by 
the celebrated Dr. Julius Wise, of Memphis, who only 
reached his bed-side a few hours before he died. Very 
few other cases occurred. 

1897. Population, 175,000. One case, a refugee. 

GALLIPOLIS. 

179G. 
This is one of the famous epidemics of history, cited 
by nearly every author on yelloAv fever. The facts are 



OHIO. 9^5 

obscure, however, and we have grave doubts that this 
outbreak was yellow fever. 

1S78. 

Population, 3,700. First cases were Chas. Degelman, 
engineer, and AVm. Koidler, of the steamer John Gibson^ 
which landed three miles below the city on August 20. 
September 11, Joseph Porter, watchman cf the John D. 
Porter^ died. His body was not permitted to be moved 
from his house, nor his wife to leave. The ^^chools closed, 
business suspended and many citizens fled. Mrs. Brown 
tlied September 27, below town, where the infected dis- 
trict was located. The disease disappeared October 17. 
Total cases, 51; total deaths, 31. 

MAPilETTA. 

1832. No statistics. 

NEWTON FALLS. 

1898. No statistics. 

BIBLIOGRAPHY OF YELLOW FEVER IN OHIO. 

Long (W. H.) : Yellow Fever at Gallipolis, 1878. Rep. Superv. Surg.- 
Ceu. Mar. Hosp., Wash., 1878-9, p. 127. 

Medaris: (Cincinnati, 1898). Ohio Med. J., 1898, vol. 9, p. 25. 

Minor (T.. C.) : Special report on yellow fever in Ohio as it ap- 
peared during the summer cf 1878. Rep. Health Dept. Cincin.; 1879, 
vol. 12, p. 173. 

Reeve (J. C): Was it a Case of Yellow Fever? Cincinnati Lancet- 
Clinic, 1879, vol. 3, p. 187. 



986 

PENNSYLVNNIA, 

BALD EAGLE VALLEY. 
1799. Sporadic cases. 

1798. Deaths, 50. 

CHESTEE COUNTY. 
1805. Sporadic cases. 

KENSINGTON. 
1793. Sporadic cases. 

LISBUEN. 
1803. First cases in August. No statistics. 
MAECUS HOOK. 

1798. First case, August. Cases, 60; deaths, 4. 

NiTTANY\ 

1799. Sporadic cases. 

PHILADELPHIA. 

1693. First appearance of yellow fever in Philadel- 
phia, according to Webster, La Eoche and Berenger- 
Feraud. No record. 

1695. Traditional outbreak. 

1699. First outbreak epidemic. Population, 3,800. 
First cases in June ; first death, July 15. Deaths, 220. 

1732. Deaths, 250. 



PENNSYLVANIA PHILADELPHIA. 9F 7 

17J:1. First case, May; first death in June; last case 
in September. Deaths, 240. 

1742; 1743; 1744. Yellow fever years. No statistics. 

1747. First case in June; last case in October. 

1760. Scattered cases. 

17G2. First case, August 28; last case, November — ; 
last death, October 30. No statistics. 

1763 ; 1789 ; 1791. YellOAv fever years. No statistics. 

1793. Great epidemic. Population, 40,144. Number 
who fled, 17,000. First case, August 18; first death, 
August 22 ; last case in December. Deaths, 4,044. 

1794; 1795; 1796. Scattered cases. 

1797. Severe epidemic. First case, August 1; last 
case, October 15. ' Deaths, 1,292. 

1798. Another great epidemic. Population, 60,000. 
First case, August 1; last death in November. Deaths, 
3,506. 

1799. Severe epidemic. First case, June 28; last case 
in October ; last death, October 18. Deaths, 1,015. 

1800. First case in July; last case in September. 
Deaths, 20. 

1801. Scattered cases. 

1802. First case in August. Cases, 598; deaths, 307. 

1803. First case, July 19 ; first death, July 25 ; last 
case, October 5; last death, October 20. Cases, 3,900; 
deaths, 195. 

1805. First case, Julv ; last case, October. 
1806; 1807; 1808; 1809; 1810: 1811; 1812; 1813; 1814; 
1815; 1816. Scattered cases. No statistics. 

1818. Cases, 2; deaths, 2. 

1819. First case, June 23. Cases, 24 ; deaths, 20. 

1820. First case, July 24 ; last case, November. Cases, 
125 ; deaths, 83. 

1826. Scattered cases. 

1853. Infected by ship Mandarin, from Cuba. First 

case, July 19 ; last case, October 7 ; last death, October 12. 
Cases, 170 ; deaths, 128. 

1854. Scattered cases. 

1870. First case, June 29. Deaths, 18. 



1^88 HISTORY OF YELLOW FEVER. 

1878. Two cases, refugees from Yicksburg, August 24. 
Cases, 4; deaths, 1. 

1879. Cases on brig Shasta, from Havti. 
1883. Cases on brig Julia Blake, from Hayana. 
1893. Cases, 3; deaths, 0. In harbor. 

PITTSBUEG. 

1878. One case from the ill-starred Jolin D. Porter^ 
died soon after arrival at Pittsburg. In o de^.elci^ments. 

SOUTHWAEK. 

1793. A suburb of Philadelphia, Yrhich see. 

BIBLIOGRAPHY OF YELLOW FEVER IN PENNSYLVANIA. 

Academy cf Medicine of PtLiladelpiia: Proofs of the Origin of the 
Yellow Fever in Philadelphia and Kensington, in the year 1797, from 
Domestic Exhalations, etc. Philadelphia, 1798. 

Account cf the Rise, Progress, and Termination of the Malignant 
Fever lately prevalent in Philadelphia. Small 8vo. Philadelphia, 1793. 

Bache (Thomas Hewson) : Observations on the Pathology of the 
Cases of Yellow Fever admitted into the Pennsylvania Hospital during 
the summer of 1853. American Journal cf the Medical Sciences, N. 
S., vol. 28, p. 121, July, 1854. 

Bond (Thomas) : An Introductory Lecture to a course of Clinical 
Lectures in the Penn. Hospital, deliveied on the 3rd of December, 
1766. North American Medical and Surgical Journal, vol. 4, p. 264. 

Caldwell (C): A Semi-annual Craticn on the Origin of Pestilential 
Diseases. Delivered before the Arademy of medicine of Philadelphia, 
17th December, 1798. Svo. Philadelphia,' 1799. 

Caldwell: Facts and Observations relative to the Origin and Nature 
of the Yellow Fever. Medical and Physical Memoirs, etc. Svo. Phila- 
delphia, ISOl. 

Caldwell: Thoughts on Febrile Miasms: Intended as an Answer to 
the Boylston Medical Prize Question for 1820, Whether fever is pro- 
duced by the decompositicn of animal or vegetable substances, etc.? 
Svo, Boston Medical and Surgical Journal, vol. 3, p. 473. 

Caldwell: An Address to the Philadelphia Medical Society on the 
Analogies between Yellow Fever and true Plague. Svo. Philadelphia, 
ISOl. 



PENNSYLVANIA. 989 

Caldwell: An Essay on the Pestilential or Yellow Fever as it pre- 
vailed in Philadelphia in the year 1805. 8vo. Appendix to Alibert. 
Philadelphia. 

Caldwell: Essays on Malaria and Temperament. 8vo. Lexington, 
1831. 

Caldwell: An Anniversary Oration on the,^ subject of Quarantine, 
delivered before the Philadelphia Medical Soci^^, on the 21st Janu- 
ary, 1807. 

Caldwell: Thoughts on Quarantine and other Sanitary Systems, 
being an escay which received the prize of the Boylston Medical Com- 
mittee of the Harvard University, August, 1834. Boston, 1834. 

Caldwell: A Reply to Dr. Haygarth's "Letter to Dr. Percival on 
Infectious Fevers," and his "Address to the College of Physicians at 
Philadelphia en the Prevention of the American Pestilence," etc. 8vo. 
Philadelphia, 1802. 

Caldwell: A Dissertation in answer to certain Prize Questions, pro- 
posed by his Grace the Duke of Holstein Oldenberg, respecting the 
Origin, Contagion, and General Philosophy of Yellow Fever, etc. 
Medical and Physical Memoirs. 8vo. Lexington, 1826. 

Caldwell: General Physiology of Yellow Fever. 1841. 

Carey (M.): Observations on Dr. Rush's Inquiry into the Origin of 
the late Epidemic Fever in Philadelphia. December, 1793. Philadel- 
phia. 

Carey (M.) : A short Account of the Malignant Fever lately pre- 
valent in Philadelphia, etc. 8vo. 1794, 

Cathi^all: Medical Sketch of the Syncchus Maligna, which prevailed 
^/^ia^hiladelphia in 1793. 8vo. Philadelphia, 1794. 

College of Physicians of Philadelphia. Proceedings relative to the 
Prevention cf the Introduction and Spreading of Contagious Diseases. 

fo7 Philadelphia, 1793. 

Ibid.: Facts and Observations relative to the Nature and Origin 
of the Pestilential Fever v/hich prevailed in this City in 1793, 1797, 
and 1798. Philadelphia, 1798. 

Ibid.: Additional Facto and Observations relative to the Nature and 
Origin of the Pestilential Fever. 8vo. Philadelphia, 1806. 

Cresson (Joshua) : Meditations, written during the prevalence of 
t|Le Yellov/ Fever in the city of Philadelphia, in the year 1793. Small 
-^Svo. London, 1803. 

Currie: A Sketch cf the Rise and Progress of the Yellow Fever, 
and of the proceedings of the Board of Health, in the year 1799. 8vo. 
Philadelphia, 1800. 

Currie (Wm.) : A Treatise on the Synochus Icterodes, or Yellow 
Fever, as it lL,tely appeared in the -city of Philadelphia. 8vo. Phila- 
delphia, 1794. 



9;^0 HISTORY OF YELLOW FEVER. 

Currie: Memoir on the Yellow Fever whic^i prevailed in PMladel- 
phia in the year 1798. 8vo. Philadelphia, 1798. 

Currie and Cathrall: Pacts and Observations en the Origin, Progress 
and Nature of the Fever which prevailed in certain parts of the city 
and di3tricts of Philadelphia in the summer and autumn of 1802; to 
which is added a Summary of the Rise and Progress of the Disease 
in Wilmington, communicated by Dr. E. A. Smith, and Dr> J. Vaughan. 
8vo. Philadelphia, 1802. 

Deveze (J.) : Recherches et Observations sur la Maladie Epidemiqae, 
qui a regno a Philadelphia en 1793, depuis le mois d'Aout jusque vers 
le milieu de Decembre. Philadelphia, 1794. French and English. 

Deveze (J.) : Dissertation sur la Fievre Jaune, qui regna a Phila- 
Kielphia, depuis le mois d'Aout, jusque vers le milieu du mois de 
Decembre, 1793. An. xii. 1804. 

Folwell. Short History of the Yellow Fever that broke out in the 
City of Philadelphia in July, 1797. 8vo. Philadelphia, 1797. 

Griffiths (S. P.): (Copy of manuscript memorandum book kept by 

during the yellow fever epidemic in Philadelphia in the year 

of 1798; with annotations by J. K. Mitchell). MS. foolscap. 

Helmuth (J. Henry C.) : A short Account of the Yellow Fever in 
Philadelphia, for the reflecting Christian. Translated from the Ger- 
man, by Charles Erdmann. 8vo. Philadelphia, 1794. 

Helmuth (J. H. C): Kurze Nachricht von den sogenannten gelben 
Fieber in Philadelphia fur den nachdenkenden Christian. 16°. Phila- 
delphia, 1793. 

History of the Yellow Fever that ^iroke out in the City of Phila- 
delphia in July, 1797. 8vo. Philadelphia, 1797. 

Jackson (Sam.): An Account cf the Yellow or Malignant Fever 
which appeared in the city of Philadelphia in the summer and autumn 
of 1820. 8vo. Philadelphia, 1821. Originally published in the Phila- 
delphia Medical and Physical Journal, vol. 1, p. 313; vol. 2, p. 1.. 

Jewell (Wilson) : Yellow or Malignant Bilious Fever in the vicinity 
of South Street wharf, Philadelphia, 1853. 8vo. Philadelphia, 1853. 
Se also Transactions of the College of Physicians of Philadelphia, 

Jones (Absalom) and Richard Alleno: A Narrative of the Proceed- 
ings of the Black People during the late awful calamity in Philadel- 
phia in 1793. 8vo. Philadelphia, 1794. 

La Roche (R.) : Remarks on the Origin of the Yellow Fever which 
prevailed in Phila. in 1853. Transactions of the College of Physicians, 
N. S., vol. 2, Phila. 

La Roche (R.): A Statement of Facts respecting the mortality oc- 
casioned by the Yellow Fever in the City of Philadelphia during the 
various epidemics from 1699 to 1620, etc. Charleston Med. Jl., Vol. 



PENNSYLVANIA. 991 

7, p. 458. 

La Roche: Remarks on the Origin of the Yellow Fever which pre- 
vailed in Philadelphia in 1853. Transactions of the College of 
Physicians, N. S., vol. 2. Philadelphia- 
Letter from the Secretary of the Commonwealth of Pennsylvania, 
relative to the late Malignant Fever. Philadelphia, 1798. 

Minutes of the Proceedings of the Committee appointed on the 14th 
September, 1793, by the Citizens of Philadelphia. 8vo. Philadelphia. 
8vo. Philadelphia, 1794. (New Edition in 1848.) 

Mitchell (T. D.) : "Why has Yellow Fever ceased to visit Philadel- 
phia as an Epidemic? N. O, M. & S. JL, vol. 9, p. 717. 

Nassy (D.): Observations en the Causes, Nature and Treatment of 
the Epidemic Disorder prevalent in Philadelphia. 8vo. (French and 
English). Philadelphia, 1793. 

Occasional essays on the yellow fever, by a Philadelphian. 8°. 
Phila., 1800. 

Parrish: -Some Account of the Appearances on Dissection in 
certain cases cf Yellow Fever, and notices of some symptoms of the 
disease as it appeared in the City Hospital in the year 1805. Coxe's 
Medical Museum, vol. 3, p. 187. 

Pascalis: An Account of the Contagious Epidemic Yellow Fever 
which prevailed in Philadelphia in the summer and autumn of 1797. 
8vo. Philadelphia, 1798. 

P^erson (J.) : Remarks on some of the Opinions of Rr. Rush re- 
,&lJecting the Yellow Fever which prevailed in Philadelphia in 1793. 
8vo. Londonderry, 1795. 

Philadelphian (A) : Interesting Essays chiefly on the subject of the 
Yellow Fever. 8vo. Philadelphia, 1820. 

Philadelphia (A.): Occasional Essays on the Yellow Fever. 8vo. 
Philadelphia, 1800. 

Purse (B. S.) : Yellow Fever and Filth. Med. Rec. N. Y., 1878, voL 
14, p. 327. 

Report of the Joint Committee of Councils relating to the Malignant 
or Pestilential Diseases of the summer and autumn of 1820, in Phila- 
delphia. Philadelphia, 1821. 

Rjj^ (Benjamin) : Letter to Dr. John Rodgers, of New York, on 
fy^Q Fever of 1793, dated October 3, 1793. Duncan's Medical Comment- 
aries, vol. 19, p. 345. 

Rush: An Inquiry into the Origin of the late Epidemic Fever in 
! ,^niladelphia. In a Letter to Dr. Redman, President of the College of 
*. Physicians. December, 1793. 

Rush: Observations upon the Origin of the Malignant Bilious Fever 
in Philadelphia, and upon the Means of preventing it. Addressed to 
the Citizens of Philadelphia, 1799. 



yil-J, HISTORY OF YELLOW FEVER. 

Rush: A Second Address to the Citizens of Philadelphia, containing 
Additional Proofs of the Doiiies::c Origin of Yellow Fever. Svo. 
Philadelphia, 1799, 

Rush: An Ancient of the Bilious Remitting Yellow Fever, as it ap- 
peared in the City of Philadelphia in the year 1793. Svo. Philadelphia, 
1794. 

Rush (B.) : Medical Inquiries and Observations. 4 vols. Phila., 1S09. 
Containing an Essays on the Xon-Contagion of Yellow Fever, and Ac- 
counts of the Epidemics of Phila. in 1793, 1794, 1797, 1798, 1799, 1802, 
1803, and 1805, and of the Sporadic Cases which occurred in 1795, 1796, 
18.00, 1801 and 1804. 
I ^"^ Shaw (Wm.) : On the Autumnal Epidemic Fever which prevailed in 
^ Philadelphia in 1803. Svo. Philadelphia, 1804. 

Stavely (A.) : A statistical history of Yellow Fever in Philadelphia, 
with a report of two cases recently treated at the Episcopal Hospital. 
Med. News, Phila., 1891, vol. 58, p. 509. 

Stuart (James) : Dissection of a Body that died of the Yellow Fever 
at Philadelphia, in the Autumn of 1805, with Practical Ooservations 
and Remarks. Medical Museum, vol. 2, p. 299. 



993 



RHODE ISLAND. 

BLOCK ISLAND. 

1801. First case in April ; first death, August 2 ; last 
case in December. 

BRISTOL. 

1795; 1796; 1797. Yellow fever years. No statistics. 

NEWPORT. 

1806. Scattered cases. 

PROVIDENCE. 

1794. Infected by a tramp ship which had communi- 
cated with vessels from West Indies. No statistics. 

1795. Deaths, 45. 

1796; 1797; 1800. Scattered cases. 

1802. Infected by ship Frassana^ from New Orleans. 
1805. Scattered cases. 

WESTERLY. 

1798 ; 1808. Scattered cases. 

BIBLIOGRAPHY OF YELLOW FEVER IN RHODE ISLAND. 

Bancroft: An Essay on Yellow Fever, p. 401. 

Berenger-Feraud: Fievre Jaune, etc., Paris, 1890, p. 81. 

Bowen (Parden) : Observations on the Origin and Nature of tlie 
Yellow Fever which, prailed in Providence (R. I.) in the summer of 
1805, in a letter to J. Hardie, Secretary of Board of Health of New 
York. Med. and (Philos. Register, vol. 4, p. 331. 

Bowen (P.) : Observations on the Foreign Origin and Contagious 
Nature of the Yellow Fever as it prevailed in Providence (R. I..), and 
other parts of the United States, in a letter to Dr. Hosack. Med. and 
Philos. Register, vol. 4, p. 341. 



994 HISTORY OF YELLGVT FEVER 

Brown (M.) : Brief remarks on the origin of yellow fever in some 
parts of tlie State of Rhode Island. Med. Reposit., X. Y., 1800, vol. 
3, p. 267-270. 

N„ Y. Med. Repository, 1805, p. 267. 

Snow (E. M.) : History of yellow fever in Providence, in years 1797, 
1800, 1803, 1805, 1820. Reprinted from the journal of June, 1857. 
[Newspaper cutting from Providence Journal, Sept. 23, 1878.] 

Wheaton (L. J.) : A Brief Account of the Yellow Fever which has 
appeared at different times in Providence, Rhode Island, with a 
Topographical Sketch of that town, and some Reflections on the use 
of Mercury. Medical Repository, vol. 10, p. 329. 

Willey (A. C.) : A short account of the j^ellow fever which ap- 
peared on Block Island, in the summer and autumn of 1801. Ibid., 
1S03, vol. 4, p. 123. 



^ 



995 

SOUTH CAROLINA, 

BEAUFORT. 

1817. Infected hj Charleston. No record of cases and 
deaths. 

1871. First case, August 6. Deaths, 7. 

CHARLESTON. 

1693; 1699; 1700; 1703; 1728; 1732; 1734; 1739; 1745; 
1748; 1749; 1753; 1755; 1761; 1762; 1768; 1770; 1792; 
1794; 1795; 1796; 1797; 1798. Yellow fever years. No 
authentic statistics. 

1799. No record of cases; deaths, 239. 

1800. No record of cases; deaths, 184. 

1801. Scattered cases. 

1802. No record of cases; deaths, 96. 

1803. Scattered cases. 

1804. No record of cases; deaths, 148. 

1805. Scattered cases. 

1807. No record of cases; total deaths, 162. 

1809 ; 1812. Scattered cases. 

1817. First case, July ; last case, November. No record 
of cases ; total deaths, 272. 

1819. First case, August; last case, October. No 
record of cases; total deaths, 177. 

1822. First case, June; last case, August. No record 
of cases, total deaths, 2. 

1824. First case, August; first death, August; last 
case, November. No record of cases; deaths, 235. 

1825. First case, August; last case, September. No 
record of cases; deaths, 2. 

1827. First case, August; last case, November. No 
record of cases; deaths, 64. 

1828. First case, August; last case, September. No 
record of cases; deaths, 26. 

1830. First case, September; last case, November. No 
record of cases ; deaths, 30. 



996 HISTORY OF YELLOW FEVER. 

1834. First case, August; last case, October. No 
record of cases; deaths, 49. 

1835. First case, August; last case, September. No 
record of cases; deaths, 25. 

1838. First case, August; last case, November. No 
record of cases; deaths, 351. 

1839. Infected bj Burmah, from Havana. First case, 
June 7 ; first death, June, 8 ; last case, October. No record 
of cases; deaths, 134. 

1840. First case, August; last case, October. No 
record of cases ; deaths, 22. 

1843. First case, November ; last case, November. No 
record of cases ; deaths, 1. 

1849. Infected by ship Numa^ from Havana. First 
case, August 6 ; last case, November. No record of cases ; 
deaths, 125. 

1852. First case, August; last case, November. No 
record of cases; deaths, 310. 

1854. Population, 50,000. Infected by Key West. 
First case. May 14; first death, August 16; last death, 
November. Cases, 20,000; deaths, 627. 

1856. First case, August ; last case, November. No 
record of cases ; deaths, 211. 

1857. First case, September ; last case, November. No 
record of cases; deaths, 13. 

1858. First case, July; last case, December; last 
death, December 22. No record of cases; deaths, 717. 

1862, Scattered cases. 

1864. First case, July 27 ; no record of cases or deaths. 

1871. First case, July 19 ; no record of cases ; deaths, 
213. 

1874. No record of cases; deaths, 37. 

' 1875. One fatal case from Savannah. 

1876. No record of cases; deaths, 27. 

1898. Charleston Quarantine. One death. 

COLUMBIA. 

1854. No statistics. 



SOUTH CAROLINA. 997 

FOKT MOULTEIE. 

1824. Population, 70 soldiers. Cases, 12; no deaths. 
1834. Infected by Charleston. Cases, 5; deaths, 2. 
1852. First case, September 7. Cases, 33; deaths, 4. 
1858. First case, August 15. No record of cases and 
deaths. 

GEOKGETOWN. 

1854. First case, August 20 ; last case, October 28. No 
record. 

HILTON HEAD. 

1862. First case, September 8; last case, October, 25. 
No record. 

JAMES ISLAND. 

1876. No record of cases ; deaths, 2. 

MOUNT PLEASANT. 

1817; 1848; 1852; 1854; 1856; 1857; 1876. Yellow 
fe^er years. No statistics. 

POET ROYAL. 

1877. No record of cases; deaths, 25. 

SULLIVAN'S ISLAND. 
1876. No statistics. 

BIBLIOGRAPHY OF YELLOW FEVER IN SOUTH CAROLINA. 

Am. Jl. Med. Sciences, vol. 32, p. 564. Epidemic of 1856.) 

An Account of the Yellow Fever of Charleston, South Carolina, as 
it appeared in the year 1817. Philadelphia Medical and Physical 
Journal, vol. 3, p. 250. 

Bancroft: Essay on Yellow Fever, pp. 352; 470. 

Byrd (H. L.) : Observations on Yellow Fever. Charleston Medical 
Journal, vol. 10, p. 329. 



998 HISTORY OF YELLOW FEVER. 

Cain (D. J.) : History of the Epidemic of Yellow Fever in Charleston, 
S. C, in 1854. Trans. American Med. Assn., 1856, vol. 9, p. 588. 

Chalmers: An Account of the Weather and Diseases of South 
Carolina, 2 vols.. 8vo. London, 1776. 

Chisolm (J. J.) : A brief Sketch of the Epidemic of Yellow Fever of 
1854 in Charleston. Charleston Medical Journal and Review, vol. 
10, p. 433. 

Currie: Observations on Dr. Tucker Harris' paper on Yellow Fever 
of Charleston, Barton's Medical and Phys. Journal, vol. 2, p.. 21. 

De Saussure (H. W.) : Statistics of the cases of Yellow Fever re- 
ceived into the Almshouse, Charleston, South Carolina, from 1840 to 
1843. Charleston Medical Journal, vol. 2, p. 3. 1847. 

Dickson: Remarks on the Yellow Fever in Charleston, South Caro- 
lina, in the Summer of 1828. Eclectic Journal, vol. 4, p. 109. 

Fever (Yellow). Epidemic in Charleston, 1849. Charleston Medical 
Journal, vol. 4. 1849. 

Harris (Tucker) : Facts and Observations, chiefly relative to the 
Yellow Fever, as it has appeared at different times in Charleston, 
South Carolina. Barton's Med. and Phys. Journal, vol. 2, p. 21.. 

Hayne (A. P.): Notes on Yellow Fever, as it prevailed in Charles- 
ton during the Summer of 1849. Charleston Medical Journal, vol. 6, 
pp. 341, 481, 627; vol. 7, p. 1. 

Hewitt. History of South Carolina. 2 vols. 8vo. London, 1779.. 

Hume: An Inquiry into some of the General and Local Causes to 
which the Endemic Origin of Yellow Fever has been attributed by 
myself and others. Charleston Medical Journal, vol. 9, p. 721. 1854. 

Hum6 (Wm.) : Meteorological and other Observations in reference 
to the cause of Yellow Fever in Charleston, etc. Charleston Med. Jl , 
vol. 5, p. 1850. 

Hume (Wm.) : On the Introduction, Propagation and Decline of the 
Yellow Fever in Charleston, during the summer of 1854.. Charleston 
Med. JL, vol. 10, p. 1855. 

Hume (Wm.) : Report to the City Council of Charleston, relative to 
the source and origin of Yellow Fever, etc. Charleston Med. JL, vol. 
9, p. 145. 

Hume (Wm.) : Sequel to Meteorological and other Observations in 
reference to the causes of Yellow Fever in Charleston, brought for- 
ward to 1852, Charleston Med. JL, vol. 8, p. 55. 

Hume (Wm.): The Yellow Fever of Charleston Considered in its 
Relation to the West India Commerce. Charleston Med. Jl. and Rev., 
1860, vol. 15, p, 1. Also: Reprint, 

Johnson: Oration delivered before the Medical Society of South 
Carolina, December 24, 1807, Svo, Charleston, 1807. 



SOUTH CAROLINA. 999 

Johnson (.Tosep.h) : Some Account of the Origin and Prevention of 
the Yellow Fever in Charleston, South Carolina. Charleston Medical 
Journal, vol.. 4, p. 154. 

Legare (Thomas) : Dissertion on the late Yellow Fever in Charles- 
ton. Svo. 1817. 

Mackall (R. C): Introduction of Yellow Fever in Savannah in the 
year 1854. Charleston Med. JL, vol. 10. p. 150. 

N. Y. Med. Repository, 1801, vol. 1, p. 217.. (Epidemics of 1700, 1732, 
1739, 1745, 1748 and 1792, in Charleston.) 

N. Y. Med. Repository, 1801, vol. 4, p. 217. (Epidemic of 1800 in 
Charleston.) 

Porter (John B.) : On the Climate and Salubrity of Fort Moultrie 
and Sullivan's Island, with Incidental Remarks on the Yellow Fever 
of the City of Charleston. American Journal of Medical Sciences, 
July and October, 1854; Ibid., January, April and October, 1855. 

Ramsay (David): Facts concerning the Yellow Fever at it ap- 
peared at Charleston, South Carolina, in 1800.. Medical Repository, 
vol. 4, p. 217. 

Ramsey: Remarks on the Fever of 1807 at Charleston. Medical 
Repository, vol. 11, p. 233. 

Ramsay: The Charleston Medical Register for the year 1802. 12mo. 

Ramsay: The History of South Carolina, etc. 2 vols. Svo. 1809. 
Ramsay (W. G.) : Observations on the cases of Yellow Fever re- 
ceived into the Marine Hospital, Charleston, from July, 1834, to Nov. 
1838. Charleston Med, JL, vol. 2, p. €35. 

Shecut (J. L. E. W.): Medical and Philosophical Essays, etc., con- 
cerning the Domestic Origin of the Yellow Fever of Charleston, South 
Carolina. 8vo. Charleston, 1819. 

Simons: A eRport read before the City Council of Charleston, with 
an Appendix, in Reply to the Report of Wm. Hume, M. D. Charleston 
Medical Journal, vol. 9, p. 329. 

Simons: A Report on the History and Causes of the Stranger's on 
Yellow Fever of Charleston. Read before the Board of Health. Svo. 
Charleston, 1839. 

Simons: An Address delivered before the South Carolina Medical 
Association, in May, 1851. Svo. Charleston, 1851. 

Simons (T. Y.) : An Essay on the Yellow Fever as it has occurred 
in Charleston, including its Origin and Progress up to the present 
time. Charleston Med. Jl., vol. 6, p. 798. 

Simons: Observations in Reply to William Hume, M. D. Charleston. 
Medical Journal, vol. 10, p. 170. 

Simons: Observations on the Yellow Fever, as it occurs in Charles- 
ton, South Carolina. The Carolina Journal, etc., vol. 1, p. 1. 



1000 HISTORY OF YELLOW FEVER, 

Simons: Reply to tlie Report of Wm. Hume, M. D. Charleston Med. 
Jl., vol. 9, p. 329. 

Strobel: Yellow Fever, etc., p. 171. (Epidemic of 1839 in Charles- 
ton.) 

Strobel: Yellow Fever, etc., p. 219. (Early epidemics in Charleston.) 

Waring: A Summary of the Climate and Epidemics of Savannah 
during the series of years from 1826 to 1829. (This is the Breakbone 
Fever, which Dr. W. regards as analogous to Yellow Fever.) North 
American and Surgical Journal, vol. 9, p. 374; vol. 10, p. 136. 

Waring (J. J.): The epidemic at Savannah, 1876; its causes; the 
measures of prevention adopted by the municipality during the ad- 
ministration of Hon. J. F. Wheaton, mayor. Savannah, Ga., 1879. 
188 p. 4 pi. 1 may. 8°. 

Yellow Fever in Charleston in 1838. American Jl. Med. Sciences, 
1838, vol. 45, p. 263. 



1001 

TENNESSEE. 

BAILEY STATION. 

1879. Infected by Mempliis. No records of cases and 
deaths. 

BAKTLETT. 

1878. First case, August 20 ; last case, October 29 ; 
last death, November 8. Cases, 74; deaths, 9 

BEACH GROVE. 
1878. One death, a refugee. 

BELL'S DEPOT. 
1878. Cases, 5 ; deaths, 3. 

BETHEL SPRINGS. 
1878. One death, a refugee. 

BROWNSVILLE. 

1873. Cases, 4; no deaths. 

1878. Number who fled, 3,000. Infected by Memphis. 
First case, August 20 ; first death, September 1 ; last case, 
October 29 ; last death, November 8. Cases, 747 : deaths, 
212. 

BUNTYN. 

1878. Throughout the epidemic of 1878, Buntyn was 
crowded with Memphis refugees, and the first case of fever 
occurred October 1st. Among the last cases was that of 
Jefferson Davis, Jr., son of ex-President Jefferson Davis. 
He died October 16th. 

1879. Infected by Memphis. Cases, 15 ; deaths, 3. 



100 if HISTORY OF YELLOW FEVER. 

CHATTANOOGA. 

1878. Number who fled, 6,000. First case, August 15; 
first death, August 21 ; last death, November 10. Cases, 
446 ; deaths, 135. 

COLLIEKSVILLE. 

1878. Number who fled, 400. Infected by Memphis. 
First death, August 24. Cases, 135; deaths?, 56. 

COVINGTON. 

1878. Population, 1,200. Almost entire population 
fled. No record of cases; deaths, 1. 

EKIN. 

1878. Population, 723. Cases, 38; deaths, 10. 

FOEEST HILL. 

1879. No statistics. 

FKAYSEE STATION- 

1878. No statistics. 

GADSDEN. 

1878. Population, 530. Cases, 6; deaths, 4. 

GALWAY. 

1878. Population, 60. Cases, 13 ; deaths, 8. 

GEKMANTOWN. 

1878. Infected W Memphis. First case, August 20. 
Cases, 89; deaths, 35. 



TENNESSEE. 1003 

GILL'S STATION. 

1878. No records of cases; deaths, 1. 

GKAND JUNCTION. 

1873. Cases, 1; deaths, 0. 

1878. Number who lied, 100. First case, August 11; 
first death, August 17. Cases, 185; deaths, 74. 

HAERISON STATION. 

1879. Population, 100. Infected by Memphis. Cafoes, 
12. 

HERNANDO EOAD. 

1879. Infected by Memphis. Cases, 4. 

HORN LAKE. 

1879. First case, September 11 ; first death, September 
14; last case, September — ; last death, September 18. 
Cases, 3; deaths, 1. 

HORN LAKE ROAD. 

1879. First case, August 20; first death, August 25. 
Cases, 13; deaths, 5. 

HUMBOLDT. 

1873. Infected by Memphis. Cases, 3; deaths, 0. , 

HUNTINGTON. 

1873. No record of cases ; deaths, 1. 

JACKSON. 

1878. No record of cases ; deaths, 3. 

KNOXVILLE. 

1878. Cases among refugees, principally from Chat- 
tanooga. 



1004 HISTORY OF YELLOW FEVER. 

LA GEANGE. 

1878. First case, September 3; first death, September 
G. Cases, 128; deaths, 37. 

MARTIN. 

1878. Number who fled, 250; first case, August 28! 
No record of cases; deaths, 40. 

MASON. 

1878. First case, August 29 ; first death, September 2. 
Cases, 61; deaths, 24. 

McCALLUM FARM. 

1879. No statistics. * 

McKENZIE. 
1878. No record of cases; deaths, 3. 
MEMPHIS. 

1828 : 1853 ; 1855 ; 1866. No statistics. 

1867. No record of cases; deaths, 231. 

1873. Infected by Cochran, Alabama. First case, 
September 14; last case, November. Cases, 10,000; 
deaths, 2,000. 

1878. Number who fled, 30,000. Infected by New 
Orleans. First case, August 6; last case, December 12. 
Cases, 18,500 ; deaths, 5,000. 

1879. Population, 40,000. Number who fled, 23,890. 
First case. May 23 ; first death, May 26. Cases, 2,010 ; 
deaths, 587. 

1897. Cases, 52; deaths, 14. 



TENNESSEE. 1005 

MILAN. 

1878. Number who fled, 1,800. Infected by Memphis. 
First case, August 26; first death, August 29. Cases, 19; 
deaths, 12. 

MOSCOW. 

1878. Number who fled, 70. Infected by Memphis. 
First case, August 21. Cases, 109; deaths, 35. 

MUEFEEESBOEO. 

1878. No record of cases ; deaths, 2. 

NASHVILLE. 

1878. Infected by Memphis. First case, August 31. 
Cases, 27; deaths, 13. 

NUBIA. 

1878. Cases, 2 ; deaths, 2. 

PAEIS AND SUBUEBS. 

1878. Nearly the whole population fled. Infected by 
Memphis. First case, August 23; last case. October 4. 
Cases, 35; deaths, 23. 

PIGEON BOOST EOAD. 

1879. No record. 

EALEIGH. 

1878. No record of cases; deaths, 14. 

EOSSVILLE. 
1878. No record of cases ; deaths, 6. 



1006 HISTORY OF BELLOW FEVER. 

SHELBY DEPOT. 

1873. No record of cases; deaths, 3. 

SHELBYVILLE. 

1879. Infected by Memphis. No record of cases; 
deaths, 1. 

SOMERVILLE. 

1878. Number who fled, 050. Infected by Memphis. 
Cases, 167; deaths, 57. 

TULLAHOMA. 

1879. One fatal case in August, from Shelbyville. 

UNION CITY. 

1878. No record of cases ; deaths, 1. 

VICE-PRESIDENT'S ISLAND. 

1879. Infected by Memphis. First and only case, 
October 8 ; died October 13. 

WHITE HAVEN. 

1878. Population, 100. Cases, 4 ; deaths, 2. 
WHITE STATION. 

1878. Infected by Memphis. First case, August 25; 
first death, August 28. Cases, 65 ; deaths, 50. 

1879. Infected by Memphis. First case, October 6. 
Cases, 1; deaths, 0. 

WILLISTON. 

187a Cases, 18; deaths, 11. 



TENNRSSEE, 1007 

WINCHESTER. 

1878. Cases, 1; deaths, 1. 

WYTHE. 

1873. Infected by Memphis. Cases, 6; deaths, 0. 
1878. No record of cases; deaths, 1. 

BIBLIOGRAPHY OF YELLOW FEVER IN TENNESSEE. 

Am. Jl. Med. Sciences, 1856, p. 624,. (Mempliis, 1828.) 

Baxter (G. A.) : Atmospheric dissemination of yellow fever, with 
methods of disenfections used at Chattanooga, and the results, Tr. 
M. Soc. Tenn., 1879, vol. 46, p. 158. 

Bougarel (C): La Fievre Jaune a Memphis. France Medicale, 
Paris, 1879, vol. 26, pp.. 533, 573 and 589. 

Cochran (J. F.) : Observations on yellow fever in Bartlett, Tenn. 
Richmond and Louisville M. J., Louisville, 1879, vol. 27, p. 1. 

Dake (J. P.) : The yellow fever of Memphis. (From, Nashville 
Daily American). Med. Counselor, Chic, 1879-80, vol. 2, p. 16, 

Dowell, p. 32. (Memphis, 1873). 

Ernskine (J. H.) : A Report on Yellow Fever as it Appeared in 
Memphis, Tenn., in 1873. Reports American Public Health Assn., 
1873, vol. 1, p. 386. 

Hamilton (F. B.) : Quarantine in Jackson, Tenn. Nashville J. M. 
& S., 1879, n. s., vol. 23, p. 53. 

Keating (J. M.) : A history of the yellow fever. The yellow fever 
epidemic of 1878, in Memphis, Tenn., embracing a complete list of the 
dead, the names of the doctors and nurses employed, names of all 
who contributed money or means, and the names and history of the 
Howards, together with the other data and lists of the dead elsewhere. 
Memphis, 1879. 454 p. roy. 8°. 

Le Monnier (Y. R.): Epidemic of Memphis in 1873. N. O. Med. & 
Surg. Jl., vol. 1, n. s., 1873-4, pp. 449, 536, 656. 

Letter from Memphis. Boston Med. & Surg. JL, vol. 101, p. 388. 

Merrill (A. P.) : On the Health and Mortality of Memphis, Tennes- 
see. A. Public Address, etc, 8vo. Memphis, 1853. 

Saunders (D, D.) : Observations on the five yellow fever epidemics 
occurring in the city of Memphis, Tennessee, Tr, M. Soc, Tennessee, 
Nashville, 1882, p. '62. 

Saunders (D. D.) : Epidemic of Memphis in 1873. N. O. Med, & 
Surg. Jl., 1873-4, vol. 1, n. s., p, 791, 



lOOS HISTORY OF YELLOW FEVER. 

Smitli (George and Tuck (W. J.): Letters on tiie Yellow Fever at 
Memphis, Tennessee, in 1S53. New Orleans Medical Journal, vol. 10, 
p. 662. 

Smith (G.) and Tuck (W. J.) : Letters on the Yellow Fever of Mem- 
phis, Tenn., in 1853. X. O. Med. Jl., vol. 10, p. 662. 

Thorton (G. B.) : The Memphis yellow fever epidemic of 1S79. 
Boston Med. and Surg. JL, 1S79, vol. 101, p. 787. 

Vanderman (J. H.) : Yellow fever in Chattanooga in 1S7S. Nash- 
ville J. M. & S., 1879, n. s., vol. 24, p. 47. 

"Wight (E. M.) : Yellow fever at Chattanooga in 1S7S; topographic, 
telluric, atmospheric and otter influences. Tr. M. Soc, Tenn., 1S79, 
vol. 46, p. 161. 



1009 

TEXAS. 

ALLEYTON. 

1867. First case, September 4; last case, December. 
No record of cases; deaths, 45. 

ANDEKSON. 

1867. No record. 

AUSTIN. 

1867. No record. 

BASTROP. 

1867. No record. 

BEAUMONT. 

1863. No record. 

1897. Cases, 1; deaths, 0. 

BELLEVILLE. 

1855. No record of cases; deaths, 1. 

BRAZORIA. 
1859. No record. 

BROWNSVILLE. 

1853. First case, September 23; last case, December 
23. No record of cases; deaths, 50. 

1862. No record. 

1879. No record. 

1882. Population, 4,500. First case, June 24: first 
death, — ; last case, November 10 ; last death, November 6. 
Cases, 1,072; deaths, 63. 



1010 HISTv^RY OF YELLOW FEVER. 

BKENHAM. 

1867. First case, August 11; last case, October 31. 
No record of cases; deaths, 120. 

CALVERT. 

1867. First case, October 12; last case, January 10, 
1868. No record of cases or deaths. 

1873. Population, 1,500. Number who fled, 900. In- 
fected by Shreveport, La. First case, September 5; first 
death, September 10; last death, December 29. Cases, 
450; deaths, 125. 

CAMEL. 

1903. Cases, 28 ; deaths, 1. 

CINCINNATI. 

1853. No record. 

CHAPEL HILL. 

1867. First case, August 8; last case, December. No 
record of cases; deaths, 123. 

COLUMBIA. 

1833; 1873; 1903. No statistics. 

CORPUS CHRISTI. 

1853. No record. 

1854. Population, 1,000. Infected by New Orleans. 
No record of cases; deaths, 30. 

1862. No record. 

1867. Infected by Indianola, Texas. First case, Au- 
gust. No record of cases or deaths. 
1873. No record. 



TEXAS. 101 1 

1882. (Eefuge Camp). First case, August 23; first 
death, August 25 ; last case, August 23 ; last death, August 
25. Cases, 4; deaths, 2. 

1903. No record. 

CORSICANA. 
1873. No record. 

CASTKOVILLE. 
1903. Cases, 1. 

CYPRESS BAY. 
1853; 1859. No statistics. 

DANVILLE. 
1867. No record. 

DE WITT COUNTY. 
1903. Cases, 5; deaths, 1. 

EDINBURG. 

1859. First case, July. No record of cases ; deaths, 13. 

GALVESTON. 

1839. Population, 1,000. First case, September 30; 
last case, October 11. No record of cases; deaths, 250. 

1844. Population, 6,000. First case, July 5. No 
No record of cases; deaths, 400. 

1847. Population, 6,000. First case, October 1; last 
case, November 25. No record of cases; deaths, 200. 

1853. Population, 8,000. First case, August 16; last 
case, November 28. No record of cases; deaths, 536. 

1854. First case, August 9 ; last case, November 5. No 
record of cases ; deaths, 404. 



1012 HISTORY OF YELLOW FEVER. 

1858. Population, 10,000. First case, August 27 ; last 
case, November 14. No record of cases; deaths, 873. 

1859. Population, 10,000. First case, September 17; 
last case, November 30. No record of cases; deaths, 183. 

1864. Population, 5,000. First case, September 1; 
last case, November 20. No record of cases; deaths, 259. 

1866. Population, 12,000. No record of cases; 
deaths, 3. 

1867. Population, 22,000. First case, June 26; last 
case, November. No record. of cases; deaths, 1,150. 

^^1870. Population, 22,500. No record of cases ; deaths, 
16. 

1873. Population, 25,000. No record of cases; 

deaths, 7. 

1882. No statistics. 

1894. No record. On vessel in harbor. 

1895. No record. On vessel in harbor. 
1897. Cases, 12; deaths, 0. On vessel. 
1905. One case, on vessel in harbor. 

GOLIAD. 

1867. First case, July 12. No record of cases; 
deaths, 23. 

HARKISBUEG JUNCTION. 

1867. No record. 

HEMPSTEAD. 

1867. First case, August 9: last case, November 25. 
No record of cases; deaths, 151. 

HOCKLEY. 

1853. No record. 

HONDO. 

1903. One case, a refugee. 



TEXAS. 1013 

HOUSTON. 

1839 ; 1844 ; 1847 ; 1848. No statistics. 
1853. Population, 7,000. First case, August 28 ; first 
death, September 4. No record of cases and deaths. 
1854; 1858; 1859; 1864. No statistics. 
1870. No record of cases ; deaths, 1. 
1897. Cases, 3; deaths, 0. Kefugees. 

HUNTSVILLE. 

1868. First case, August 9; last case, October 19. No 
record of cases ; deaths, 130. 

INDEPENDENCE, 

1867. No record. 

INDIANOLA. 

1852. No record. 

1853. Population, 1,000. Infected by New Orleans. 
First case, August 30. No record of cases; deaths, 106. 

1858; 1859; 1862. No statistics. 

1867. Infected by ship Margarita from Vera Cruz. 
First case, June 20. iNo record of cases ; deaths, 80. 

LA GKANGE. 

1867. First case, August; last ca^se, December. No 
record of cases; deaths, 200. 

LAREDO. 

1903. Cases, 1.008; deaths, 107. 

1904. Cases, 10. 

LIBERTY. 

1867. No record. 



10] 4 HISTORY OF YELLOW FEVER. 

LIVEKPOOL. 

1853. First case, August. Xo record of cases; 
deaths, 4. 

LYXCHBUEG. 

1853. Scattered cases. Xo statistics. 

MATAGOEDA. 

1862. X^o record of cases; deaths, 120. 

1863. Xo record. 

MILLICAX. 
1861. Xo record. 

1867. First case, October 15; last case, Xovember 12. 
Xo record of cases; deaths, 1. 

MIXEKA. 
1903. Cases, 137; deaths, 16. 

XAVASOTA. 

1867. First case, August 12 ; last case, December. Xo 
record of cases; deaths, 151. 

OLDTOWX. 

1867. Xo record. 

PALAEYAXA. 

1882. Infected bv Point Isabel, Texas. Cases, 18; 
deaths, 2. 

POIXT ISABEL. 

1853. X'o record. 

1882. First case, August 29. Cases, 208. 

POET LAYACA. 
1867. First case, July 3; last case, October 2"^, Xo 
record of cases or deaths. 



TEXAS. 1015 

RICHMOND. 

1853; 1859. No record. 

EIO GRANDE CITY. 

1867. No record. 

SABINE CITY. 

1853. Population, 200. First case, July; last case, 
October 1. No record of cases ; deaths, 14. 

1863. First case, July; last case, October 1. No 
record of cases; deaths, 14. 

SALINA. 
1853. No record. 

SALUVIA. 

1853. No record. 

SAN ANTONIO. 
1903. Cases, 43; deaths, 16. 

SAN JACINTO. 
(See Lynchburg). 

SANTA MARIA. 

1882. First case, October 24; first death, October 29. 
Cases, 3; deaths, 0. 

SUGARLAND. 

1859. No record. 

VELASCO. 

1853. Infected by New Orleans. No record. 

VICTORIA. 

1867. First case, August 1; last case, December 25. 
No record of cases; deaths, 200. 



1016 HISTORY OF YELLOW FEVER. 

BIBLIOGRAPHY OF YELLOW FEVER IN TEXAS. 

Bowers (J. M.) : The yellow fever epidemic at Columbus, Tex., 
October, 1873. Letter to Dr. C. O. Weller. Texas Med. JL, Austin, 
1903, p. 164, vol. 19. 

Dinwiddle (R. L.) : Yellow fever; the Laredo epidemic. Tr. Texas 
M. Assn., Austin, 1904, vol. 36, p. 140. 

Goldberger: Transactions on account of the yellow fever at Laredo, 
Tex. Pub. Health Rep. U. S. Mar. Hosp. Serv., Wash., 1904, vol. 19, 
p. 962. 

Guiteras (G. M.) : Report on the epidemic of yellow fever of 1903, 
at Laredo, Minera, and Cannel, Texas. Rep. Surg.-Gen. Pub. Health 
& Mar. Hosp. Serv., U. S. Wash., 1904, p. 303. 

Guiteras (G. M.) : The yellow fever epidemic of 1903 at Laredo, Tex. 
J. Am. M. Assn., Chicago, 1904, vol. 43, p. 115. 

Harrison (R. H.) : Yellow Fever Reports. Texas Med. News, Austin, 
1896-7, vol. 6, p. 490. 

Heard (T. J.) : On the Topography, Diseases and Climate of Wash- 
ington, Texas. Trans Amer. Med. Assn., 1856, vol. 9, p. 690. 

McCraven (W.): On the Yellow Fever of Houston, Tex., in 1847. 
N.O. Med. and Surg. JL, vol. 5, 1848-9, p. 227. 

Parker (D.) : Facts and Conclusions in Regard to the Calvert 
Epidemic of 1873. Trans. Tex. Med. Assn., 1878, vol. 10, p. 164. 

Purnell (J. H.) : Report of conditions existing in San Antonio, Tex., 
and vicinity with relation to preventing spread of yellow fever. Pub. 
Health Rep. U. S. Mar. Hosp. Serv., Wash., 1903, vol. 17, p. 1768. 

Purnell (J. H.) : Transactions on account of yellow fever at Laredo, 
Tex. Pub. Health Rep. U. S. Mar. Hosp. Serv., Wash., 1904, vol. 19, 
p. 715. 

Reuss (J. M.): An outbreak of yellow in DeWitt County. Tr. Texas 
M. Assn., Austin, 1904, vol. 36, p. 135. 

Richardson (T. F.): Yellow Fever in DeWitt Co. (Texas). U. S. 
Public Health Reports, 1903, vol. 17, p. 1925. 

Smith: An Account of the Yellow Fever which appeared in the 
City of Galveston, Republic of Texas, in the Autumn of 1838, with 
Cases and Dissections. 12mo. Galveston, 1839. 

Smith (A.) : Med. Topography of the City of Galveston, Tex., with 
an Account of the Symptoms and Pathology of the Yellow Fever which 
prevailed in that City in the Autumn of 1839. Amer. Jl. of Med. 
Scien., vol. 25, p. 499. 

Smith (Ashbel). Yellow Fever of Houston, Texas, in 1853. See 
Fenner's Report, vol. 7, of the Transactions of the American Medical 
Association, p. 530. 



TEXAS. 1017 

Fenner (E. D.) : On the Yellow Fever of Norfolk and Portsmouth, 
Va. Trans. American Med. Assn., 1856, vol. 9, p. 711. 

Hazen (C. M.) : Yellow fever in Virginia. Med. Reg. Richmond, 
1899-1900, vol. 3, p. 137.. 

Koiner (A. Z.): The case of (transported) yellow fever in Rich- 
mond. Virginia M. Month., Richmond, 1878, vol. 5, p. 668. 

Mitchell: Additional Observations on the Yellow Fever of Virginia, 
addressed to Dr. Franklin. American Medical and Philosophical 
Register, vol. 4, p. 383. 

Mitchell John) : Letter to Governor Golden, containing an Account 
of the Yellow Fever as it appeared in Virginia in 1737, 1741, 1742,. 
Medical Museum, vol. 1, p. 1. See also Medical and Philosophical 
Register of New York, vol. 4, p.. 181. 

Tabor {G. R.) : The 1903 epidemic of yellow fever in Texas, and the 
lesson to be learned from it. Austin, 1905, 22p. 8°. Forms No. 64, of 
Bull. Univ. Tex. Med. Series No. 3. 

Thayer (A. E.) : Study of a case of yellow fever. (Galveston, 1905.) 
Med. Rec, N. Y., 1907, vol. 71, p. 45. 

Wassam (A. M.): The recent yellow fever scare in Southwest 
Texas. Southern Clinic, Richmond, 1898, vol. 21, p. 33. 

West (H. A.): Yellow Fever in Galveston. Phila. Med. Jl., 1898, 
vol. 1, p. 685. 



1018 

VIRGINIA. 

ABINGDON. 

1878. First and only case was Judge L. Y. Dixon, a 
refugee from Memphis, who died September 17. 

ALEXANDEIA. 

1796. No statistics. 

BELLONA AESENAL. 

1829. No record of cases ; deaths, 1. 

BOWEK'S HILL. 

1855. Infected by steamer Ben Franklin from St. 
Thomas, West Indies. First case, July; first death, Au- 
gust; last case, July; last death, — . Cases, 2; deaths, 2. 

CAPE CHAKLES QUARANTINE. 

1893. Cases, 3. 

1894. No record of cases; deaths, 2. 

1897. No record. 

1898. Cases, 2; deaths, 1. 

CAPE HENRY. 
1894. Cases, 3. 

CITY POINT. 

1798. No record. 

FORTRESS MONROE. 

1888. Infected by Spanish bark, Buenaventura^ from 
Havana. One case, October 26, terminating in death on 
the 27th. 



VIRGINIA. 1019 

GOSPORT. 
1855. No record. 

HAMPTON ROADS. 

1869. No record. 

1883. Infected by yessels. No record of cases or deaths. 

1899. At National Soldiers' Home. Source of infec- 
tion undetermined, but "an old soldier," who had recently 
arrived from Santiago de Cuba and was taken ill at the 
Home, thought to have been original focus. First case 
died July 2S. Depopulation resorted to by U. S. Marine 
Hospital authorities, with such good results, that out of 
the 3,500 inmates of the Home, only 45 contracted the 
fever. Mortality 13. Last death, August 7. 

Onlj one case occurred outside of the above limits, name- 
ly, in the town of Phoebus, directly ''across the creek" from 
Hampton, the source of infection being plainly traced to 
the Home. 

NORFOLK. 

1737; 1741; 1742; 1747; 1789; 1794; 1795; 1796; 1797; 
1798 ; 1799 ; 1800 ; 1801 ; 1802 ; 1803 ; 1804 ; 1805. Yellow 
fever years. No statistics. 

1821. First case, August 1. No record of cases or 
deaths. 

1825; 1826. No statistics. 

1848. Infected by Vandalia. Cases, 2; deaths, 0. 

1852. Cases, 3 ; deaths, 3. 

1854. No statistics. 

1855. First case, June 30; last case, October. No 
record of cases ; deaths, 1,807. Infected by Ben Fi^anklin, 
St. Thomas, West Indies. 

1878. No record of cases; deaths, 1. 

PETERSBURG. 
1798. No statistics. 



lOiO HISTORY OF YELLOW FEVKR. 

PHOEBUS. 

1899. Cases, 1; deaths, 0. 

POETSMOUTH. 

1834. One death. 

1852^. Cases, 4; deaths, 4. 

1854. Infected by French ship, CJiimere, from West 
Indies. Cases, 7; deaths, 2. 

1855. Infected by Xorfolk. Xo complete statistics. 

KICHMOND. 

1806. No statistics. 
1878. One case, a refugee. 

SCOTT'S CKEEK. 

1855. No statistics. 

WINCHESTEE. 

1802; 1803. Scattered cases. No statistics. 

1804. First case in July. No record of cases and 
deaths. 

1871. One fatal case. 

BIBLIOGRAPHY OF YELLOW FEVER IN VIRGINIA. 

Acher (Robert) : History of the Yellow Fever, as it appeared at 
Norfolk during tlie summer and autumn of 1821. Medical Recorder, 
vol. 5, p. 60. 

Armstrong (G. D.) : The summer of the pestilence. A history of 
the ravages of the yellow fever in Norfolk, Va,, A. D. 1855. 12°. 
Phila., 1856. 

Golden: Observations on the Yellow Fever of Virginia, with some 
Remarks on Dr. J. Mitchell's account of the Disease. In a Letter to 
Dr. J. Mitchell, of Virginia. Medical and Philosophical Register, vol. 
4, p. 378. 

Donaldson (F.): Yellow Fever at Hampton, Va. Medical News, 
1899, vol. 75, p. 240. 



' VIRGINIA. 1021 

Ramsay (W. G., of Norfolk, Va.) : Letter to Dr. Mitchell concerning 
the Pestilential Sickness in Norfolk in the summer and autumn of 
1795. Webster's Collection, p. 154. 

Report of the origin of the yellow fever in Norfolk during the 
summer of 1855. Made to city council by a committee of physicians. 
8°, Richmond, 1857. 

Selden and Whitehead: On the Yellow Fever at Norfolk, Virginia, 
in the Summer and Autumn of 1800. Medical Repository, vol. 4, p. 
320; Ibid., vol. 6, p. 247. 

Stephenson (F. B.) : Yellow fever at Norfolk, and Portsmouth, Va , 
in 1855. Proc. Nav. Med. Soc, Wash., 1882-3, vol. 1, p. 84. 

Stoi'rs (R. S., Jr.): Terrors of the pestilence; a sermon, preached 
in the church of the Pilgrims, Brooklyn, N. Y., on occasion of a col- 
lection in aid of the sufferers at Norfolk, Va., September 30, 1855. 8*. 
New York, 1855. 

Yellow fever in the National Soldiers Home, near Hampton, Va. 
Pub.. Health eRp. U. S. Mar. Hosp. Serv., Wash., 1899, vol. 14, pp. 
1253. 1309, 1359. 



1022 

VERMONT. 

GEAND ISLE. 

1789. Condie and Folwell (p. 98), state that yellow 
fever caused "considerable mortality in Grand Isle in 
1798." Source of infection not stated. 

KOYALTON. 

1798. Epidemic ( Condie and Folwell, loc cit. ) No 
statistics. 

WINDSOE. 

1798. The same authorities state "a similar fever" pre- 
vailed at Windsor in 1798. No statistics. 

BIBLIOGRAPHY OF YELLOW FEVER IN VERMONT. 

r " 

Condie and Folwell: History of the Pestilence commonly called 
Yellow Fever, which almost desolated Philadelphia in the months of 
August, September and October, 1798. Philadelphia (no date), pp. 
97, 98. 



1023 

WASHINGTON- 

rORT TOWNSEND QUARANTINE. 

1897; 1902. Infected vessels from South Alner!caii 
ports. No cases erupted at Quarantine or in the city. 

BIBLIOGRAPHY OF YELLOW FEVER IN WASHINGTON. 

U. S. Public Health Reports, 1897, p. 1041. 
Ibid., 1902, p. 2539, 



1024 

WEST VIRGINIA 

wheeli:n^g. 

1878. One case, a refugee. 



PART IV, 



YELLOW FEVER 



EPIDEMIC 



OF 



1905. 



EXPEEIENCES DUEING THE YELLOW FEVEK 
EPIDEMIC OF 1905. 

By Henry Dickson Bruns, M. D., New Orleans, La. 

As '^all experieuce is an arch where thro' gleams the 
untravell'd world," and as no faithfnl account of any 
portion of a great event by an eyewitness can be wholly 
useless or uninteresting, I have decided to offer you these 
notes of my experience during the epidemic of 1905 — the 
more as I was engaged not as a practitioner, but as a 
volunteer sanitary laborer, but seeing and acting always 
from the viewpoint of the medical man. You all know 
how the summer of 1905 wore uneventfully along, until 
the latter part of July, when a sudden "slump" in stocks 
set all male gossips agog seeking an explanation. You 
recall how, in casting about to finance the immediately 
necessary sanitary work, our health offlcers called to- 
gether the representatives of the associated banks and 
made known to them the secret, and how, like all secrets 
communicated to more than one person, it soon became 
the common property of the town. On July the 21st the 
news reached my ears; on Thursday, the 25th, it was un- 
obtrusively published in the newspapers. That night I 
received a note asking me to meet certain neighbors on 
the evening of the 26th in the basement of Trinity Church. 
Those invited all lived in the middle portion of the Tenth 
Ward, and the meeting, it was well understood, was to 
devise means to place our immediate surroundings in the 
best possible sanitary condition with the least possible 
waste of time. The Tenth Ward of New Orleans, you 
must know, runs from the river to the swamp, and from 
Felicity to First Streets. Meetings of citizens had already 
been called and volunteer work had already begun in sev- 
eral of the other wards. 

Reporting at the designated time and place, I found 
present the Rev. Beverley Warner, the signer of the call ; 
Dr. Joseph Holt, Messrs. Hunt and William Henderson, 



1028 axgustin's history of yellow fever. 

Mr. Hewes Gurley, Mr. George Leverich, Capt. Eobert 
Perrin, Messrs. Charles and Arthur Palfrey, Capt. I. L. 
Lyons, Mr. Eobert B. Parker, Dr. G. King Logan, Mr. 
Harry Charles, Mr. George Allain, Dr. Allan Eustis, Dr. 
L. G.^LeBeuf and Mr. Hoffman. 

With little ado the meetins: was ors^anized by calling 
me to the chair. Without debate it was decided that the 
first thing to be done to combat invasion of our neighbor- 
hood by the fever was to make our cisterns impossible to 
the stegomyitie as breeding places. To do this, according 
to the scientific knowledge of the day, it would be neces- 
sary to oil them (pour upon the surface of the water a 
small quantity of coal oil) and next to cover their tops in 
such a way that no opening larger than one-sixteenth of 
of inch square should remain unclosed. Secondly, that 
all premises should be frequently inspected and all stand- 
ing water poured out, drained away or oiled, and all cess- 
pools, and privy vaults cleansed and oiled not less than 
once a week. Primarily our efforts were to be directed 
to covering ("screening- was the word universally 
adopted) as rapidly as might be consistent with thorough- 
ness, our employees endeavoring to extend their useftil- 
ness by warning and instructing householders as to the 
need and the mode of cleansing and keeping their 
premises so as to make them inhospitable to the mosquito. 
As a matter of course, money wotild be at once needed, 
and the chair was authorized to appoint a finance and 
other necessary committees. He was also asked to" be- 
come the organizer and director of the work. I accepted 
on the express condition that I shotild have absolutely 
nothing to do with the raising or handling of the funds. 
The condition being agreed to, having no faith in the per- 
formance of large committees — especially where time is a 
consideration — I appointed Mr. Htmt Henderson chair- 
man of the Finance Committee, with power to appoint 
other members if he chose, and Dr. Joseph Holt and Dr. 
G. King Logan as medical advisers and assistants. Dr. 
Holt continued to act as adviser whenever called upon 
until our work ended, and Dr. Logan was our active 



PERSONAL EXPERIENCES, 1905 BRUNS. 1029 

lieutenant untU he was appointed Acting Assistant Sur- 
geon in the Public Health and Marine Hospital Service. 
It was understood by all that our work would at first 
be confined to that part of the ward represented by the 
gentlemen present — a considerable strip lying between 
Magazine and Baronne Streets. We would do all in our 
power to put it in such order that the health officials 
might be relieved of all care about it. AfterAvards, if 
time and means alloAved, and it should prove agreeable 
to the residents of a larger area of the ward, we might, 
gradually extend the limit of our endeavor. For at this 
time it was the common impression that the State and 
city health authorities were about to begin a campaign 
of cleaning, draining, oiling and cistern closing along the 
river front of each Avard, progressing steadily toward the 
rear or swamp boundary. Evidently, if, upon reaching 
the middle or wealthier portion of the wards, they could 
be found already in satisfactory order, not only great 
expense and labor, but — what then was even more precious 
— time would be saved. It is needless to say that no 
adequate idea prevailed of the magnitude or cost of such 
a task ; or of the extent of the infection and the difficulties 
of sanitation in the original infected district; conditions 
which at once began to absorb all the efforts and resources 
of the State and Cit}^ Health Boards, rendering it impos- 
sible for them to throw any force worth speaking of into 
parts of the city, as yet slightly or totally uninvaded. It 
was this inadequacy of means to the end which broufijht 
about the appeal to the United States for assistance and 
the supplanting of the local sanitary authorities by the 
national — the United States Public Health and Marine 
Hospital Service. Yet, looking back, there is reason to 
believe that had our Health Boards pursued a course 
similar to the national organization's, had they appealed 
at once to the community for a third of a million as 
sinews of war, had they put every ward in the city in 
charge of a medical man of sense and character and estab- 
lished a detention hospital or hospitals, under men of 
experience, they might have done as well. That the money 
was forthcoming the event showed; that the men were 



1030 augustin's history of yellow feykr. 

ayailable was proven by the taking into its service of some 
two score of our younger physicians by the Public Health 
and Marine Hospital Service, and the numerous capable 
volunteer and paid workers who were immediately de- 
veloped by the citizens' aid associations. 

But to return from this digression : Dr. Beverley War- 
ner very kindly placed the basement of his church 
(Trinity), together with its large yard, at our service as 
a headquarters. The offer was gratefully accepted, and 
the meeting adjourned. It may be stated at once that the 
resolution to keep distinct the financial and executive de- 
partments of our work was rigidly adhered to. All con- 
tributions to the fund were made to and acknowledged by 
the chairman of the Finance Committee, or in his absence 
by Gapt. I. L. Lyons. The final statement prepared by 
him shows that the total amount collected was |1,486, 
of which an unexpended balance of $234 was, by mutual 
agreement, turned over to the Eev. Beverley Warner, 
superintendent of volunteer ward organizations, and was 
by him covered into the general fund raised by the citi- 
zens in fulfillment of their promise to the United States 
Public Health and Marine Hospital Service; so that our 
work cost us almost $33 for each of the thirty-eight blocks 
worked over. Save in emergencies, nearly all supplies 
were brought through a purchasing agent, a position 
which Mr. Hewes Gurley kindly volunteered to fill. The 
approved bills were paid by our treasurer. He also paid 
the weekly clerical and labor payrolls prepared by our 
offtce force, so that every bill passed through at least two 
hands and no question as to the misapplication of a cent 
could possibly arise. The final statement already referred 
to contains many interesting data as to the amount ot 
material consumed in protecting the thirty-eight rather 
thinly-built-up blocks in the area of work. ^For instance, 
we used no less than 290 pounds of bill posters' tacks, 41 
hammers, 23 pairs of shears, 58 balls of twine, 3 dozen 
sacking needles, 6 gross of large safety pins and IT ex- 
tension ladders, besides many one and twc-sallon oil cans, 
several large and small tin funnels, barrel faucets, scratch 
pads and bill files. All these not consumed in service 



PERSONAL EXPERIENCES, 1905 BRUNS. 1031 

we turned over to the Public Health and Marine Hospital 
Service officer in charge of the ward on the completion of 
our work. Seven barrels of oil were given us by the Gen- 
eral Citizens' Committee; of which we used four and re- 
turned over three to the Public Health and Marine Hos- 
pital Service Acting Assistant Surgeon. Unfortunately 
no exact idea of the amount of cloth consumed can be 
arrived at, because a large quantity of cotton cloth of 
excellent quality was given us by the Maginnis Cotton 
Mills, and because, until we had finished ^'screening'' and 
were engaged only in inspecting and repairing, all other 
cloth was purchased and presented to us by Mr. Kobert 
Parker. That, during the work of inspection and repair 
alone, we found it necessary to use no less than 1,034 2-3 
yards at a cost of |38.82 faintly indicates the great quan- 
tity consumed. Another donation, six barrels of creosote, 
given us by Mr. Sylvester Labrot, was experimented with 
in treating gutters, both stagnant and flowing. It was 
found very useful, for its specific gravity being high it 
sinks and continues for a long time to produce an oily 
film upon the surface of the water. On this account, and 
by reason of its antiseptic and deodorizing properties 
also, a half and half mixture with coal oil was found to 
be the best material for treating privy- vaults ( Dr. Samuel 
Logan, Acting Assistant Surgeon, Public Health and 
Marine Hospital Service) and exposed pools, from the sur- 
face of which coal oil scum quickly evaporates. 

Our first day, July 27, was mainly occupied in finding 
proper foremen, but work was begun. From the start 
we determined to send out no workmen except under 
trustAvorthy and intelligent foremen, and we were for- 
tunate in obtaining men. A few were secured on July 
27, and the others in the next day or two. They were: 
L. Mitchell, E. F. Salerno, C. P. May and E. C. Finlay, 
under-graduates of Tulane Medical Department; C. J. 
Chapotin, C. Kubel, A. M. Warner, George Upton and 
the Rev. George Summey, editor of the ^'Southwestern 
Presbyterian," a volunteer. The course of Dr. Summey 
cannot be too highly praised. Quietly, without in any 
way seeking notoriety, he abandoned his professional and 



1032 augustin's history of yellow fever, 

editorial labors and devoted his whole time to working as 
an oiling and screening foreman. The wisdom of secur- 
ing entirely competent foremen before putting any 
laborers in the field became more and more apparent as 
we went on. Not only were the men kept steadily at 
work and all questions of ^'soldiering'' eliminated, but 
great loss of time in getting to work in the morning, in 
keeping well provided with material and in deciding 
promptly upon the correct solution of many difficult little 
mechanical problems of thorough cistern covering, which 
frequently arose, were prevented. These foremen rapidly 
got together a highly efficient body of workmen, as they 
were given full power to employ and discharge, and the 
lazy or incompetent were soon weeded out. Indeed, fail- 
ure to secure the right kind of foremen and to grant them 
these powers, together with the intrusion of political in- 
fluences which insisted upon the employment of dwellers 
in a ward upon work in that ward, regardless of fitness 
or sobriety, often forcing the retention of men, drunken, 
inept or incompetent, seemed the chief source of wasteful 
expenditure and inefficient work which I observed in 
some parts of the city. Our foremen and clerks (except 
the volunteers) received two dollars a day, and our 
laborers one dollar and fifty cents. The largest number 
of laborers employed was seventy-five and the smallest, 
six. Our highest weekly payroll was |502.15, and the 
lowest, $66.75. The opportunity to earn this money at 
the height of the dull summer season and during a time 
of epidemic was a godsend to a large number of men, 
some middle-aged with dependent families, but the largest 
number young and single. The quality of labor we were 
able to engage was quite extraordinary, consisting of 
clerks and minor railroad employees of every kind, factory 
hands, mechanics, etc. — all men of intelligence and en- 
ergy. Many were young fellows who had come here 
during the prosperous winter, obtained work, been dis- 
charged when quarantine confined the business of the 
city, and who were thus enabled not only to support them- 
selves, but to lay aside enough to pay for transportation 
to other, and for the time more favorable, fields of 



PERSONAL EXPEIENCES, 1905 BRUNS. 1038 

employment. The same was true, of course, tliron^liont 
the city, and the money put into circulation in the execu- 
tion of sanitary work and for material was instrumental 
in conyerting what must otherwise haye been a season of 
poyertj and priyation to the masses into one of compar- 
atiye prosperity and comfort. What a contrast to the 
old days, when under a yisitation of the yellow plague 
there was nothing to be done but to sit still, to suffer 
and to die! Hoiw often is wisdom not only justified of 
her children, but of her collateral descendants! 

/We began work knowing that wire gauze was unob- 
tainable in the city and that our screening must be done 
with cloth. We made use of three qualities, being always 
glad to use what we could g^t, and generally being unable 
to choose what we would take. One was a gccd cheese- 
cloth heayy enough to be used in single thickness ; another, 
a much more sleasy material, requiring to be doubled to 
be of sufficient strength, and the third, the material giyen 
by the Maginnis Mills, good heayy coarse sheeting and 
good light duck. This we found far and away the best, 
and our experience led us to belieye it more suited eyen 
to permanent work than wire gauze because, being more 
pliable, it can be more exactly applied to the closing of 
minute cracks by the ayerage workman, and, if well 
painted oyer, it must proye more durable, for eyery 
variety, saye the yery expensiye true bronze-wire gauze, 
rapidly corrodes. 

Our first day's experience showed that, besides the ob- 
viously necessary barrels of coal oil and the extension 
ladders, five and two gallon oil cans, tin funnels, barrel 
spigots, hammers and tacks, shears, sacking needles and 
twine, and large safety pins were needed for cutting and 
fastening the cloth. Our men tried, but quickly rejected 
one after the other, all the suggested oiling devices, from 
bottles tied to poles to tin cans which opened when 
pressed upon the cistern rim. Some of these Avere found 
difficult and time-consuming to fill, others could net be 
introduced behind the overhanging eaves of certain types 
of cisterns, while still others were more likely to shoAver 
their contents upon the heads of the users than within 



1034 augustin's history of yellow fever. 

the cisterns to be oiled. They were all superseded by a 
ladder and a common pint or quart beer or wine bottle. 
These could be handily carried by a string tied around 
the neck, rapidly filled by means of a funnel, and easily 
poked into and emptied through any opening in a covered 
cistern. After the first day there arose a loud demand 
from the workmen for carpenters' aprons to hold their 
tacks and small tools while working on the ladders, and 
for tacks with heads guarded by pasteboard, as they held 
the cloth better and could be more rapidly used. To 
supply these needs we asked the assistance of the ladies 
of the neighborhood, and in a day of two they furnished 
us with more than two dozen carpenters' aprons of cheap 
ticking and no end of pasteboard cut into squares of about 
one inch. The whole leisure time of our office force and 
of all our Tisitors was spent in pushing tacks through 
these pasteboard squares, but during the height of the 
work the demand exceeded this supply, and we were 
obliged to engage two small boys at a quarter of a dollar 
a day. The speed developed by these little professionals, 
their rivalry and their devices for facilitating their Avcrk 
afforded us all much amusement. 

Early experience showed the best working unit to be 
a foreman and two laborers for an oiling gang, and three 
laborers for a screening gang. In the oiling gang this 
allowed two laborers to carry the extension ladder, their 
bottles and a two-gallon oil can each, while the foreman 
usually carried an extra oil can. In the screening gang, 
two laborers, if the cistern were large, worked on the 
ladders, while the third and foreman, who directed the 
A^^ork, assisted in moving the ladders, handing up the 
material, helping to drape the cloth, etc. If the cisterns 
were small two of the laborers worked at one and the 
foreman and the remaining man at another. Toward the 
beginning of the second week many of our foremen were 
able to work two or even three gangs of three men each 
upon the cisterns of contiguous properties; but the reit- 
erated instructions to all were thoroughness and diligence, 
but no more speed than was compatible with efficient 
work. The route from premise to premise was usually 



PERSONAL EXPERIENCES, 1905 BRUNS. 1035 

by means of their ladders over back fences. Thus unoc- 
cupied premises were reached as rapidly as occupied ones, 
and the front streets, as a rule, presented no evidence of 
the presence of the workers. Occasionally a ladder or a 
big oil can standing by a front fence, a wagon cloth and 
laddar laden, its sleepy driver lolled upon the seat, its 
hang-dog-looking mule somnambulistically stamping flies 
beneath the torrid sun, would serve to guide the executive 
who wished to drop in unawares to see how^ his men were 
getting on. Two wagons were used during the whole of 
our work, save for the last few days of reinspection. One 
was furnished by Mr. Eobert Parker, the diriver being 
paid by us; the other, together with its driver, was sup- 
plied by the Messrs. Henderson. During the first days 
they hauled the oil barrels and deposited them in the 
yards of obliging citizens at convenient points throughout 
the district ; thej carried fresh supplies to the oiling gangs 
as the contents of their cans were used up ; and, on morm 
ings when oiling was to be begun at a distance from 
headquarters, they carried the men, their ladders and 
their oil to the starting point. After the first five days, 
when oiling had been completed and the oil barrels had 
been hauled back to headquarters, they hauled the ladders 
and material to the starting points every morning, and 
were fairly busy all day hauling extra material or trans- 
porting gangs, which had completed one block, to a new 
one. When not employed they reported to headquarters 
and remained in its immediate vicinity iready to be dis- 
patched on any errand. 

Our office force, composed of Dr. G. King Logan, Cap- 
tain Robert Perrin (volunteer), Mr. C. C. Waterman, 
Mr. George Leverich and Dr. J. D. Weis (volunteer), 
soon had everything systematized and working with 
machine-like smoothness. Our day's work began at 7 a. 
m., and at that hour of each summer's morning I found 
one or two members of the office force, the foreman and 
their gangs, and the two wagons assembled before the 
basement of Trinity Church. The doors were unlocked, 
the bijg gates of the yard swung open, and a scene of 
orderly haste and bustle began. The gangs loaded their 



1036 augustin's history of yellow feyer. 

ladders and the day's supplies of cloth upon the Tvagons, 
and then each foreman received from one of the ojfice 
men, stationed at a windo^v opening on the Tajd, oil cans, 
funnels and a box containing tacks, carpenters' aprons, 
hammers, shears and all things needed by his gang for 
the day. These boxes were also placed in the wagons and 
away they went to the parts of the district wherein work 
was to be pushed during the day. At 6 p. m. the wagons 
loaded with the boxes and ladders returned. The two 
ladders belonging to each gang, tied together and properly 
numbered were stored in the yai^d. Oil cans and work 
boxes were passed by the foremen through the window 
to a member of the office force, who looked to see that all 
tcMs taken cut were returned. Each foreman handed 
his day's report to another member of the office force, 
who had charge of that iDarticular, and the day's work 
was at an end. 

Owing to the varying density with which the squares 
in the territory were built up and the great differences in 
size of cisterns encountered, to avoid also any stimulus 
to hasty work by the excitement of rivalry between our 
foremen, no effort was made to keep account of the num- 
ber of vaults and cisterns oiled and screened daily. In- 
stead, a large diagTammatic map of the thirty-eight 
squares, showing their city numbers and the streets 
bounding them, was prepared and posted upon one wall 
of our headquarters. As the oiling was completed on a 
square, a blue circle containing the date was drawn upon 
the square indicated on the map; when the screening of 
a square was finished a red cross holding within its arms 
the date was drawn. Every morning a general order 
directing each foreman to the square that he and his gang 
would be employed upon during the day was hung upon 
a bill-file near the map. If a square had been so far 
completed during one day it was sure to be finished the 
next, then the general order would indicate the square 
to which the gang should next proceed. In this way a 
glance at the map told not only how the work was pro- 
ceeding and how long a time had elapsed since a partic- 
ular square had been oiled or screened, but just where 



PERSONAL EXPERIENCES, 1905 BRUNS. 103? 

every foreman and his gang might be found at any par- 
ticular time if need arose to communicate with him, send 
additional supplies, etc., as very often happened. Extra 
material needed through the day was issued upon a writ- 
ten requisition upon headquarters by a foreman. '''■ 
material was issued by a member of the office force, one 
of whom was always present, and the requisition hung 
on a bill-file kept for that purpose and properly labeled. 
Foremen were supplied with small scratch pads. On the 
first leaf, under the date of each day, they copied from 
the general order their assignment, and on the following 
leaves kept account, by street and number, of the premises 
visited, and the number of vaults and cisterns oiled and 
screened at each. They also jotted down the presence of 
any nuisan'ce on any premise and anything else note- 
worthy. The last leaf bore the names of the gang em- 
ployed under that foreman during the day and was signed 
by him. From these reports the daily labor roll could be 
made out without fear of mistake or contradiction. AH 
reports of nuisances, improperly wire-screened cisterns, 
old wells which should be filled, pools or butts of stand- 
ing water, were hung upon a file. Evejy night these were 
taken up by a special volunteer aid (Dr. Joseph D. Weis), 
who devoted himself to this task, writing and mailing a 
courteous note to the property holder asking for a recti- 
fication of the condition. The number of concealed cis- 
terns (many in small back rooms), of old unused wells 
(some under but slightly raised buildings), or paitly 
buried water-butts, shallow ponds, etc., discovered in the 
comparatively small area under our care, was astonish- 
ing. A wall file was also kept for the posting of com- 
plaints of proiDcrty holders, and these you may be sure 
were numerous and varied. Many seemed unable to real- 
ize that damage to a piece of rotten gutter pipe was far 
more than compensated by the value of the cistern 
screening being done for them at public expense. How- 
ever, each complaint was taken up and attended to, and 
in the end, we believe, to every one satisfactorily. It will 
be seen that hanging bill-files played a large part in 
systematizing our work. It was found the least trouble- 



10S8 augustin's history of yellow fever. 

some way of keeping all kinds of memoranda and 
accounts in a business of emergency like this. Indeed, 
the walls of our headquarters were covered with rows of 
files, each surmounted by a label indicating its purpose. 
Only two books were kept, one, the property book, an 
inrentory of our tools and stores entered as they were 
purchased; the other, the alphabetical payroll made up 
from the daily reports of the foremen for the laborers and 
for the office force by our chief clerk. An imjDortant file, 
called the "Skij) Book,'' hung from a nail in the wall. It 
contained a list of particularly difficult jobs of cistern 
covering. For it came to pass that, during the first rusn 
of the screening gangs over the district, certain cisterns 
were left unscreened, either bv^cause they were overlooked 
or were hidden away in houses or sheds, when they were 
usually reported to us by tenants, or because they were 
of such size, height or other difficult nattire as to be 
beyond the skill of the first gang which encountered them. 
Those unfamiliar with Xew Orleans must know that 
the main drinking-water supply is from rain collected 
from the roofs in wooden containers like railroad tanks, 
and almost always fitted with covers. Many of these 
receptacles are arranged one above the other in two or 
even three tiers or stories, so that the top of the highest 
may be level with or even a little above the house roof. 
They are to be seen of every diameter and height. The 
covers may be of plank, in which case they are often old 
and rotten or constructed of sheet-iron over wooden 
frames, conical, dome or minaret shaped, and these often 
present seam-cracks or rtist-holes. Many very wide cis- 
terns, twelve to fifteen feet in diameter, without covers 
of any sort, were met with. The ''skips'- were for the 
most part of this character, and a gang of specially handy- 
men under a foreman of exceptional intelligence and 
aptitude was constantly engaged in dealing with them. 
In this Messrs. Summey and Horton rendered valuable 
service. In covering large cisterns with very rotten tops 
or none at all, a ladder had to be passed across the top 
from one point on the rim to another, and a rude frame 
of boards or scantling constructed. A laro;e sheet made 



PERSONAL EXPERIENCES, 1905 BRUNS. 1 059 

by sewing breadths of cloth together, the seams being 
carefullT wrapped in and stitched with twine, was; then 
drawn over the frame and tacked down all around. In 
screening to cover cracks and holes in sheet iron domes, 
similar sheets had to be made and wrapped about these 
cupolas. Sometimes poncha-like discs with a central hole 
were slipped over the spike, which, like that on a German 
helmet, often adorns these metallic domes, and were 
fastened down everywhere to the side of the cistern. In 
the case of a large cistern encased in cement, into Avhich 
tacks could not be driven, the cloth cover Avas allowed 
to depend far down and then draAvn close to the cistern 
circumference AAitli cord passed around and around it. 
Many of the ways in which the cloth was fitted close 
around awkAvard inlet and outlet pipes did credit to the 
American reputation for ingenuity. Indeed, these inlet 
and outlet pipes were a subject of much concern to all 
engaged in cistern coA^ering. At first we enclosed outlet 
pipes satisfactorily by putting a square of cloth over the 
loAver end, gathering the edges close about the pipe and 
securing them in this position by wrapping around and 
around AAith tAvine. But sometimes trash accumulated 
at the loAA^er end of the pipe, behind the cloth, and caused 
stoppage. Later a better plan, suggested by one of the 
Marine Hospital surgeons, of fastening with cord to the 
lower end of the pipe a slecA^e of cotton cloth about 
eighteen inches long, was adopted. When the cistern 
overflowed water passed freely through the sleeve at the 
end of the pipe; when the flow ceased the cloth collapsed 
and prevented the ingress of mosquitoes. Inlet pipes 
coming from the roof gutters we at first closed by plug- 
ging the (opening from the gutter into the pipe Avith a 
cone made of wire gauze painted to prcA^ent rusting. The 
cone, about six inches across the top, could be pushed 
tightly into the opening of A^arious sized pipes, effectually 
sealing them against the entrance of anything more than 
one-sixteenth of an inch in diameter. They could be 
quickly made by rolling up a square of wire gauze, as 
a cornucopia is made from a sheet of paper, and fastened 
by a few turns of wire raA^eled from the edge of tfiei 



1040 augustin's history of yellow fever. 

gauze. A handy workman was kept making them, and 
we used up many dozen ; sixty-six feet of yard- wide gauze 
being consumed before we abandoned this method. The 
cones were given up partly on account of the impossibility 
of getting fine gauze and partly because householders 
objected to them, on the ground that trash washed down 
the roof gutter would dam against the cone edges and 
cause the roof gutter to overflow. I confess, however, 
that it seemed to me better that this should occasionally 
happen than that the trash should find entrance into my 
cistern, as the cone could easily be pulled out and the 
gutter cleaned whenever necessary. We substituted the 
same sleeves that were tied over the ends of outlet pipes. 
Where the cistern end of the inlet pipe could be readily 
got at, the sleeve was tied over its open end just as with 
the outlet pipes. Where the cistern end of the inlet 
pipe was within the cistern cover and not get-at-able, the 
sleeve was passed into the inlet pipe at its origin from 
the roof gutter; then a straight bit of elastic steel about 
a foot long, and one-sixteenth inch thick, and a half ot 
an inch wide, was curled into a circle and passed just 
within the mouth of the sleeve. When released it ex- 
ipanded to the circumference of the pipe and held the 
mouth of the sleeve closely applied to the pipe's inner 
surface. For these sleeves we were also indebted to the 
ladies of our neighborhood, who had several hundred 
made for us at a cost of five dollars. 

Our main task was completed at about the time that 
the Health and Marine Hospital Service office, under Act- 
ing Assistant Surgeon Samuel Logan, was established in 
the ward. For the sake of greater ease of co-operation, 
our headquarters were, therefore, now moved to the com- 
modious building occupied as headquarters by Dr. Logan. 
Our force, which had been gradually reduced as the work 
drew to completion, was cut down to two gangs of a fore- 
man and three men each. These were, naturally, selected 
from among the most conscientious, experienced and in- 
genious of all who had been in our employ. On August 9th 
they began a systematic, minute inspection of all screen- 
ing work. Their orders were to re-oil any cistern found 



PERSONAL EXPERIENCES, 1905 BRUNS. 1041 

defective and to leave all mosquito-tight behind them. 
One wagon was retained to carry the ladders, cloth and 
other material to and from work. Following instruc- 
tions, the foremen themselyes mounted the ladders and 
insi3ected every foot of screening at close range, examin- 
ing especially the cistern tops and the inlet and the outlet 
pipes. If any defect was found the cistern was oiled, the 
men were instructed how to make it mosquito-tight, and 
exact completion of these repairs carefully overseen. At 
the same time an additional lookout for standing water, 
hidden wells, or other nuisances was kept, and all such 
were noted in the foreman's daily report. These reports 
were at once turned in to Acting Assistant Surgeon 
Logan, who instituted instant and energetic measures for 
the treatment and abolition of these nuisances. Although 
we thought our screening had been exceptionally well 
done, and always under repeated instructions to prefer 
thoroughness to speed, yet so many were the damages in- 
nicted by wind and weather, and so numerous the other 
small defects and omissions discovered on critical review 
that it took twenty days to go over the territory (thirty- 
eight blocks) and make all perfect. The wire screening 
at this time being put on by private contractors to replace 
our cloth proved especially defective and vexatious. Those 
engaged in wire screening seemed, for the most part, to 
have failed to grasp its purpose and to be unable to realize 
that a gap of over one-sixteenth of an inch makes a whole 
job useless. They seemed to think that anything which 
would exclude an English sparrow would answer the 
purpose. 

As soon as this first inspection was finished (August 
29th) reinspection was begun. Those blocks which had 
first been given to one inspector were now assigned to the 
other and vice versa. By Sept. Tth, this second inspection 
being virtually completed, and the acting assistant sur- 
geon of the Public Health and Marine Hospital Service 
having the whole sanitary work of the ward well in hand, 
I could see no reason for the maintenance of an extra 
cog to the machinery. I therefore closed our office. The 
ladders and other implements on hand were, after con- 



1042 augustin's history of yellow fever. 

sultation with those interested, turned over to the Public 
Health and Marine Hospital Service officer ; our accounts 
were balanced by Captain I. L. Lyons, our acting chair- 
man of the Finance Committee, the cash surplus donated 
through Dr. Warner to the Citizens" Auxiliary Commit- 
tee, and our work was done. 

It is pleasant in looking back to be able to beliere that 
we accomplished what we set out to do : To make a belt 
across this large and populous ward so thoroughly oiled 
and screened as to be mosquito-proof, and thus to save to 
the central authorities care, expense and, above all, time. 
The area, six by six blocks, was sufficiently large to form 
an interesting experiment. So far as I know it was the 
only district in which volunteer sanitary work was carried 
on from beginning to end under the constant personal 
supervision of a medical man. By all testimony the 
stegomyia, though not as extinct as the dodo, became in 
the center of this tract a curiosity. Ai^ound some of its 
edges, where our neighbors were not so well protected 
until the Public Health and Marine Hospital Service took 
hold of the work, I am told that many could be found. 
The area became infected seventeen times; the first time 
in the last days of July, but so far as we know the in- 
fection never spread but in a single instance — in the 
square at the corner of Camp and Felicity Streets. Ten 
times out of the seventeen the infection occurred on the 
boundaries of the area. It occurred six times on the 
Camp Street and three times on the Baronne Street 
boundary; never on the First Street boundary. 

One may be sure that the experience of our men was 
checkered with incidents both pleasant and unpleasant 
during their forty-five days' campaign. Though for the 
most jjart the people acquiesced very good-naturedly in 
what was being done for the common weal, the belief 
in the mosquito theory was by no means universal. One 
hard-headed old Irishwoman obdurately refused to allow 
her cistern to be oiled. When finally persuaded by one 
of the most diplomatic of our foremen she exclaimed: 
"Well, come in and do it, if yez is bound to, but I don't 
believe yez can keep the Lord from gittin' those He wants 



PERSONAL EXPERIENCES, 1905 BRUNS. 1043 

by puttin' a little ile on the cistlierns." The most un- 
pleasant incident had to do with ward politics. After we 
had been at work about a day and a half, the political 
•leader of the ward called a meeting to '^organize the 
ward.'' This meeting was attended by nearly all, if not 
all, the gentlemen who had been pi^esent at the Trinity 
Church meeting and others from the central division. 
The meeting was organized by the ward leader, and all 
motions carried and all nominations confirmed were made 
or suggested by him. The ward was divided into three 
sections. The middle one, extending from Camp to 
Baronne Street, was confided to our care. It was resolved 
that the chairman of the meeting and the executives of 
the three divisions should meet and appoint a Finance 
Committee to have charge of collections and disburse- 
ments for the whole ward. The gentlemen from the central 
division, at whose instance I had begun the work, were 
without confidence in sanitary work conducted under 
political auspices. I was unwilling to direct such work 
in co-operation with a Finance Committee for whose 
appointment I should share responsibility, but in whose 
selection I should, at best, have but one vote out of three. 
We therefore left the meeting and determined to continue 
our work independently. Afterwards a rumor was cir- 
culated that the wealthier inhabitants of the central divi- 
sion selfishly subscribed money to protect themselves 
alone and left their poorer neighlDors of the front and rear 
to meet the cost of sanitary work as best they could. This 
is untrue. I know that more than a score of the well-to- 
do living in the middle division contributed to the oiling 
and screening in all three divisions; many most gener- 
ously to the ward funds and to the general fund besides. 
That more whom I do not know did so is highly probable. 
The slow progress of our first inspection, which took 
twenty days, was the subject of some disagreeable criti- 
cism. I mention it here to emphasize the difficulty and 
the time-consuming nature of this work when thoroughly 
done. It was said that our men were not doing their 
duty, but were dawdling over their work for the purpose 
of drawing pay for a longer time. The accusation was 



1044 augustin's history of yellow fever. 

ridiculous. First, the two foremen in charge of inspec- 
tion and repair were selected from the large number who 
had been in our employ by reason of their trustworthi- 
ness, diligence and skill. Their characters to those who 
know them are refutation enough. Secondly, their work 
was not done in secret, but under the eyes of the many 
Public Health and Marine Hospital Service men who were 
constantly about the premises where they were employed, 
of the citizens in whose yards they worked and under my 
;own, for I frequently dropped in upon them at unex- 
pected times. Thirdly, a like opinion has never been 
heard from any who closely followed this kind of work. 
On the contrary, that two gangs of four each could have 
thorougholy covered thirty-eight blocks in twenty days 
has seemed to them evidence of remarkable industry. A 
reliable man of experience stated that he had found in 
one block in another district twenty-six cisterns, supposed 
to be properly screened, which were lamentable defective 
and which would have required many days to repair 
effectually. Such criticism shows ignorance of the prac- 
tical difficulties to be overcome in so closing the various 
types of cisterns in any district of New Orleans as to 
make them absolutely mosquito-tight. 

Suggestions. 

The experience of our summer's work resulted in the 
following reflections : 

That the attempt to screen during an epidemic is most 
unfortunate. During such a time of stress the work is hur- 
riedly and imperfectly done and cisterns which are really 
open to the mosquito are supposed to be properly closed. 
Too much attention is concentrated upon this work and 
the search for other standing water is neglected. These 
and the cesspools remain unemptied or unoiled and con- 
stitute a source of great danger. It would be far better 
during the actual prevalance of the disease to concentrate 
all attention and all work upon keeping every cistern 
properly oiled and reoiled, upon seeking out and emptying 
or oiling every body of standing waater, and upon the 
thorousfh fumigation and refumisration of dwellings. 



PERSONAL EXPERIENCES, 1905 BRUNS. 1045 

The thorough screening of cisterns so as to leave no 
opening larger than one-sixteenth of an inch can only be 
done by skilled workmen. A very common fault in this 
work is the neglect to carry the wire gauze or other! 
material a foot or two doAvn the sides of the cistern. The 
staves of many cisterns do not come close together at the 
top, and, especially in dry spells, there are large cracks 
between the staves, extending down a foot or more from 
the top through which any mosquito can readily pass. 

Inspection and reinspection of the screening are as im- 
portant as the work itself, and must be thoroughly, in- 
telligently and conscientiously done to be of value. In 
practice it was found impossible to do this work with less 
than two workmen to move about the long extension lad- 
ders and a foreman o^ greater sagacity and fidelity to 
observe, note and direct the necessary repairs. Inspec- 
tion done from the ground, done in any way than by going 
over the whole work minutely from a ladder-top, is worse 
than useless, in that it establishes a false belief in safety 
where no safety exists. The work too, if well done, is 
tediously slow, and many gangs Avill be required to in- 
spect a whole city within any reasonable time. Unless 
our health authorities are particularly careful and for- 
tunate in the selection of their employees for this wc-ric, 
the foundation of a calamity will be laid. It is certain 
that the average city employe possesses neither the intel- 
ligence noir the fidelity to be a foreman of such work. 
Eeinspection is necessary because most of the material 
commonly used is very perishable. Only the best quality 
of bronze wire effectively resists the constant action of 
air and water. It is a pity that the screening ordinance 
does not permit the use of a good quality of duck. Our 
experience led us to the conviction that this material can 
be more closely and effectively applied by the ordinary 
workman than wire gauze, and when oil painted it cer- 
tainly lasts longer. The objection that it prevents 
adequate aeration of the water is without force. It is 
practically impossible to close hermetically a wooden cis- 
tern. Eain water is charged to saturation as it falls: 
coolness and darkness are unfavorable to vegetable and 



1046 AUGUSTINS HISTORY OF YELLOW FEVER. 

therefore to animal life, and make for purity of the con- 
tained water. As it is impossible to know how long de- 
fects may have existed before they are found, all cisterns 
with gaps more than one-sixteenth of an inch should be 
at once reoiled by the inspectors. 

There can be but little doubt that the Stegomyia, what, 
ever may be her habits now, will, if driven to it, take to 
depositing her eggs in gutter water and that the larvae 
will learn to endure their new environment. Hence it is 
of the greatest importance not only that underground 
drainage and sewerage should be pushed to completion 
as rapidly as possible, but that paving with asphalt, upon 
which unbroken surfaces must be maintained, should go 
hand in hand with this work. The asphalt pavement, 
sloping gradually to the curb, leaves no deep gutter in 
which stagnant pools can be maintained. Wherever tne 
Wlork has been done in such fashion as to leave these, it 
should be remodeled without delay, and where the neces- 
sities of heavy hauling demand material other than 
asphalt, it should be so laid as to abolish forever the old- 
fashioned deep gutter. A comparison of the gutters on 
Gravier Street from Camp Street to Baronne with those 
on Howard Avenue from St. Charles to Baronne ; of those 
on Poydras Street from Camp to Baronne with those on 
Girod between the same streets, and of those on St. 
Charles Street between Julia and Girod with those on 
Carondelet between the same streets, will give a striking 
illustration of the importance of this work and the need 
for prompt remodeling. 

In some cities the tenant is required by law to sweep 
or cause to be swept down every morning the stretch of 
gutter before his house. The ordinance is easily enforced 
by a word from the policeman on the beat to the house- 
holder or his servant, and all are easily educated to the 
advantages of the plan. It appears that such an ordi- 
nance would be specially useful in this city. 

An experience with even a very limited area showed 
that this old city is peculiarly rich in hidden wells, cis- 
terns and other containers. I beg to suggest that ai^ 



PERSONAL EXPERIENCES, 1905 BRUNS. 1047 

important part of the work of our health officers in pre- 
paring for the coming summer should consist in obtain- 
ing as complete a knowledge of the location of these 
containers as possible. This could be done by urging all 
citizens possessing such knowledge to communicate it at 
once to the health authorities either directly or through 
the public press. We found last summer that many 
tenants were unaware of the presence of such sources of 
danger on their premises, and we often obtained knowl- 
edg of them in an indirect way from former tenants or 
builders of the houses. The search for all unscreened 
bodies of standing water on all premises cannot be pushed 
with too great a vigor if we are to exterminate the 
Stegomyia. 

May I be permitted to say that perhaps the health 
authorities might enlist the services of the physicians of 
the city as volunteer inspectors of premises, alleys, etc? 
The general practitioner on his rounds penetrates into 
every quarter and into almost every dwelling of the city. 
In furtherance of the general good these gentlemen might 
be persuaded to note down and report to- the health officer 
every threatening nuisance which comes under their eyes 
without any uncomfortable use being made of their names. 
It seems to me also that it has become eminently a 
part of our duty to encourage by word and example the 
sentiment that, its mode of propagation being well under- 
stood, yellow fever has been robbed of its terrors and is 
no more to be regarded with panic-terror by intelligent 
people than an outbreak of small-pox or diphtheria. As 
we in small-pox, by the vaccination of all non-immunes, 
and in diphtheria by the bold use of the serum, both as a 
prophylactic and a cure, proceed at once to stamp out 
what were in times past two of the most mortal plagues, 
so now upon the appearance of yellow fever we can by the 
prompt report of all suspicious cases, and their proper 
protection either at home or in detention hospitals, by th© 
thorough fumigation of infected dwellings, and by reduc- 
ing to the least possible number all breeding places of the 
Stegomyia, cut down to a minimum the mortality, and 
therefore the dread, of this one-time scourge. This must 



1048 augustin's history of yellow fever. 

folloAV as the logical result of our newly acquired knowl- 
edge; and when it is coupled with a calm appreciation of 
the utter lack of protection aftorded by even the most 
rigid quarantine, so glaringly illustrated by the epidemic 
of last summer in this State, yellow fever will take its 
place in the popular mind along side of small-pox, diph- 
theria and rabies^ — as a disease to be avoided, but nO' 
longer capable of striking whole communities with sense- 
less fear, canceling their humanity and exalting above 
manly sentiment the brutish instinct of self-preservation. 

Perhaps it is Utopian as yet even to hope, but the day 
must come when, if we are to be protected in our health 
and lives by sanitary officials, these, more than any of 
our public officers, will be chosen by the application of the 
strictest of civil service laws. We can imagine, if we 
cannot hope for, boards of health composed of a chief 
sanitary officer and two or three assistants; subordinate 
to them a body of inspectors, and clerks of vital statistics, 
each receiving a salary sufficient to compensate him for 
devoting his life to this important work. Admission to 
the lowest grade of this profession — say a clerkship of 
vital statistics — would be open to young medical men of 
good character. Upon a vacancy occurring in the next 
highest grade — let us say that of inspector^ — a successful 
competitive re-examination would promote the brightest 
of the clerks ; and so on to assistant to the chief sanitary 
officer, and finally to that of chief, when that official 
should be retired after a long, but fixed, period of service. 
To some such method the inevitable processes of evolution 
must lead at last. 

But, come what may, through the long years that we 
are developing wisdom enough to choose the protectors 
of ou'r lives and of lives dearer to us than our own by 
some better test, some higher qualification, than that of 
political subservience, we should at least be too proudly 
manful to fear and falter beneath afflictions that follow 
as the night the day, the folly of our own acts. 



1049 

SOME LESSONS TAUGHT BY THE EPIDEMIC OF 

1905. i 

By Charles Chassaignac^ M. D., New Orleans. 

Dean Neio Orleans Polyclinic; Editor ^^Neio Orleans 
Medical and Surgical Journal/^ etc. { 

In this short article, the attempt will be made to call 
attention to some of the most important practical lessons 
which may be learned from many things which occurred 
during the prevalence of yellow fever in Louisiana and 
Mississippi in 1905. 

I shall cull from my personal observation during that 
time, perhaps from previous experience viewed in a new 
light, and as well from the work of others. ;In other 
words, a few of my deductions may prove to be new to 
some readers, while others, no doubt, will be recognized 
as merely new interpretations of old knowledge or ex- 
planations of facts previously not understood. 

Truth of Mosquito Propagation. 

The correctness of the mosquito doctrine was confirmed 
on a larger scale and at a larger number of places than 
ever before. That mosquitoes are the sole known prac- 
tical means of the propagation of yellow fever was demon- 
strated in the City of New Orleans beyond a reasonable 
doubt. 

When the existence of the scourge became known, it 
was still early in summer, in July, the same month that 
it became epidemic in 1853. It was soon discovered that 
numerous foci already existed, located at different parts 
of the city. The type of fever was recognized to be 
severe; an old and esteemed practitioner then stated to 
the author that its virulence reminded him of that of the 
fever of 1853. The percentajo^e of non-immunes among 
the inhabitants was large, owing to the large increase in 
population since the last mild epidemic and to the fact 
that the last severe pestilence had occurred twenty-seven 



1050 augustin's history of yellow fever. 

years previous. To sum up the situation, all conditions 
were such as to lead the thoughtful to expect an epidemic 
of vast proportions, high mortality and long duration. 

What actually happened was this: The total number 
of cases oiiicially reported was 3,384 with a mortality of 
451, about 13%. As always, many cases must have failed 
of report, while deaths were necessarily reported. The 
fever was over about the first of November, although the 
first frost occurred only on December 5, and the funds 
raised for the sanitary campaign were not exhausted. 

The only difference in the warfare waged against the 
pestilence in 1905 and that of previous campaigns was 
that measures were based solely on the mosquito doctrine : 
the protection of the sick against the bites of mosquitoes 
by means of screens, mosquito bars, &c. ; the killing of 
mosquitoes in infected premises, chiefly with sulphur 
fumes; also the gradual destruction and elimination of 
all Stegomyia by general fumigation, the screening oi 
cisterns and other water containers. The education of 
the public at meetings and lectures were auxiliary 
methods of material assistance. 

Not only there was no general exodus of non-immunes, 
but 01^ those who did go away, none took sick who re- 
turned after the disease was under control and before the 
occurrence of frost. Formerly this was a danger against 
which people had been warned ; invariably, a few of those 
who did not heed the warning fell sick shortly after their 
return, owing to the lack of destruction of infected 
mosquitoes. 

Why, then, this enormous difference in the prevalence, 
the mortality and the duration of the epidemic? Why 
should there have been in 1853, when the fever became 
epidemic in the same month, a mortality of 7,849 ; in 
1878, when the fever was epidemic a month later, a mor- 
tality of 4,056, or respectively about eighteen and nine 
times greater than in 1905, when the population had 
largely increased? Why should the epidemic have been 
arrested before frost for the first time in the history of 
the disease in New Orleans, although there yet remained 
a large percentage of non-immunes? 



LESSONS TAUGHT BY EPIDEMIC OF 1905 CHASSAIGNAC 1051 

Because the mosquito doctrine was for the first time 
the basis of the work done for the control of the disease 
and, notwithstanding the formidable difficulties encoun- 
tered, it proved eminently successful. 

Similar results followed analogous measures at many 
localities in Louisiana and Mississippi. I shall relate 
only a striking instance as observed directly by me in 
Tallulah, in Madison Parish, where I was requested to go 
by the president lOf the State Board of Health in the 
middle of September. 

The infection had been brought there on July 21. The 
first suspicious cases were discovered about August 9. 
Precautionary measures taken after the confirmation of 
the diagnosis, gave rise to the hope that there would be 
no further cases and a greater sense of confidence was 
engendered by the statement, on August 26, that all cases 
of illness in the town had been critically examined by a 
representative of the Public Health and Marine Service 
w^ho declared that there Avas not a suspicion of yellow 
fever in the town. 

Owing to this the people threw caution to the winds, 
screens were torn out because they increased the heat, 
persons about to flee decided to remain. By the end of the 
month undoubted and severe cases were recognized, and on 
September 5 there were at least twenty cases among the 
comparatively small white population, while fatalities 
among the best known people gTadually wrought the popu- 
lation to a high pitch of excitement and panic. Many fled, 
including prominent officials, the terror being intensified 
because practically all were non-immunes, the little town 
never before having had a visitation of the scourge, and 
because of the high rate of mortality. ' 

Arriving on September 11, I found that over a dozen 
deaths had occurred and that of the forty town blocks, 
all but three or four were infected; in other words, the 
infection was general. The only water supply was de- 
rived from cisterns, tanks, barrels and wells, and the 
town w^as swarming with stegomyia mosquitoes. 

An anti-mosquito campaign was inaugurated at once; 
all water containers were oiled within twenty- four hours ; 



1052 augustin's history of yellow fever. 

the sick were screened or protected bv netting ; systematic 
fumigation was carried on Tigorouslv; latrines were 
treated with crude oil and lime. 

Within a week the number of new cases, which had 
been progressively increasing, were diminishing and by 
the end of September, long before frost, the epidemic was 
over, althotigh a census taken at that time showed that 
there were yet not fewer than 200 non-immunes who had 
no-t had the fever. 

Confirmatory evidence in a negative sense is not lack- 
ing. Eeferring to only one notable instance, I shall quote 
from the report of the State Board of Health in regard 
to Patterson, La., where "conditions were such as to make 
it practically impossible to control the people, and the 
fever, although repeatedly checked, ran its course until 
frost." This and a few analogous experiences of both 
types showed that there was that year no exceptional 
tendency in the fever to end early, but that where the 
mosquito fight was properly carried out the outbreak was 
stopi^ed before frost, otherwise it continued as usual until 
frost. 

Infection in Proportion to Xiomher of Bites. 

A lesson taught also by occurrences in 1905 is that, 
other things equal, the degree of virulence of the infection 
is probably due to the number of bites by infected mos- 
quitoes received by the victim. It is natural this should 
be so as there is no poison known, animal or vegetable, 
organic or inorganic, the effects of which are not in pro- 
portion to the dose. The more bites the larger the dose. 

My attention was attracted to this point early during 
my stay in Tallulah. The houses in which the infection 
had been most severe, as evidenced by the ntimber both 
of cases and of fatalities were those where mosquitoes 
abounded, where water receptacles were most numerous. 

An interesting and significant contrast was shown in 
the history of two practitioners who both did courageous 
and useful work in the ill-fated village. 

One was a young physician employed by the State 
Board of Health, who thought himself immune as he had 



LESSONS TAUGHT BY EPIDEMIC OF 1905 CHASSAIGNAC. 1053 

had a slight attack during- a previous epidemic, and who 
labored faithfully without thinking of taking any pre- 
cautions. More than once during the first days he showed 
me the bites he had received while on his morning or his 
evening round, considering them somewhat as a joke and 
mentioning how^ he had watched some of the insects at 
work. In less than ten days after he went on duty he 
was stricken with a characteristic attack of yellow fever, 
being apparently overwhelmed by the toxemia and suc- 
cumbing early, notwithstanding his youth and the de- 
voted care he received. 

The other was an older practitioner, a local man, who 
had never been exposed to the disease and frankly ac- 
knowledged his fear of it, nothwithstanding which he did 
his duty as nobly as the other. The difference is that he 
used all possible precautions, sleeping in a screened house, 
smearing his face and hands with pennyroyal frequently, 
using a fan, and otherwise dodging mosquitoes as best he 
could. This man escaped the fever, or, as I believe, four 
ov five days after receiving the only noticeable bite he 
suffered, he had the slightest kind of a walking case, 
well-nigh imperceptible. 

The surroundings, the work, the degree of fatigue were 
the same in both men. ^he psychic element, the age, the 
comparative immunity weis^ all in favor of the one who 
contracted the disease in a virulent and fatal form. The 
conclusion seems obvious. 

In line with the facts just mentioned it must be recalled 
that it has been asserted previously, especially by the 
French observers in Brazil, that the number of bites were 
the bites of one mosquito produced only a mild attack. 

Virulence Diminishes ^^Pari Passu^^ tcith the Destruction 

of Mosquitoes. 

For the reasons given above, systematic fumigation, 
and the destruction of mosquitoes by any other means, 
first shows its effect by a reduction in the mortality rate, 
by a decrease in the intensity of the symptoms in those 
stricken. This can be understood easily. As soon as 



1054 augustin's history of yellow fever. 

the number of infected mosquitoes is materially lessened, 
it stands to reason that those who are unfortunate enough 
to be bitten at all are likely to receiye fewer bites than 
those who became yictims when there were yet numerous 
hordes of the dangerous pests. As long as there are any 
infected mosquitoes at all and also non-immunes exposed 
to their bites, so long must there break out some cases of 
fever, hence the length of time that usually elapses before 
the yery last case is observed; in a much shorter time 
enough mosquitoes are destroyed to cut down the average 
number of bites received by those who are exposed, con- 
sequently the virulence is diminished long before the dis- 
ease is completely arrested. 

This was shown conclusively by the course of events 
in Xew Orleans during 1905. For July, before the san- 
itary campaign was effective, the rate of mortality among 
the reported cases was 20% ; for August it dropped to 
13%; yhile for the other two months of the epidemic it 
averaged 11.5. 

In Tallulah, this was observed also. The fatalities were 
most numerous just before the inauguration of active 
warfare against mosquitoes and they diminished steadily 
thereafter. So much so that no one died of yellow fever 
who took sick after the work was well started but the 
much regretted young physician whose case has already 
been outlined and was exceptional in more ways than one. 
The mortality was arrested first, then the severity of the 
cases further decreased noticeably some time before the 
epidemic was over. 

Susceptibility of Xegroes. 

It was shown conclusively during 1905 that negroes 
are about as liable to contract the disease as the whites, 
but that they have it usually in a remarkably mild form. 
There again a valuable illustration can be obtained from 
Tallulah and vicinity : of 90 white cases, 18 died, or 20% ; 
of about 950 colored cases, only 5 died, or little over 1/2%. 
In Lake Providence and vicinity, of 80 whites who were 
stricken, 15 died, or nearly 20%, while, of 217 colored 



LESSONS TAUGHT RY EPIDEMIC OF ISOS — CHASSAIGNAC. 1055 

patients, 8 died, or a little more than 3%. There were 
reported from Patterson about 500 cases among the white, 
with a mortality of 51, yet, of about 200 colored cases> 
only one died. 

Several negroes were observed by me in Tallulah, who 
had symptoms just about sufficient to make a diagnosis 
possible, yet who were scarcely sick, some not even inter- 
rupting their work. At first very few of the darkies re- 
ported their sick and it was only when it became bruited 
about that the sick were supplied with delicacies, especi- 
ally chicken during convalescence, that we obtained any 
idea of the large number who were having the disease. 

The difference between the morbidity in the two races 
might be explained by the greater resistance of the blacks 
to the poison after its entrance in the system, but I am 
inclined to the belief that it is because, other things equal, 
the black man receives a smaller dose of the poison owing 
to the fact that he gets bitten less. This may be due to 
his tougher skin, or to the strong musky smell coming 
from his surface which may keep the mosquitoes away 
in a way analogous to that of pennyroyal and other strong 
scents which are used with that end in view^ 

Be that as it may, we all know that mosquitoes are less 
felt by the colored than by the whites, and 1905 showed 
that negroes are just as prone to contract yellow fever 
as their white neighbors, but have it in a very mild form. 

This is an exceedingly important lesson for obvious 
reasons, as it was formerly thought that the negroes were 
practically immune and cases among them must have 
been overlooked easily and frequently. 

Quarantines Umntelligent. 

Numerous occurrences, illustrating different phases of 
the subject, have shown that the kind of quarantines re- 
sorted to up to 1905 were, to say the least, unintelligent 
because they either were unnecessary, on the one hand, 
or did not attain their purpose, on the other. Quaran- 
tines other than those against persons w^ho might be 
infected or objects that might carry infected mosquitoes 
were proved to be unnecessary by the large number of 



1056 

places which remained free of the disease notwithstanding 
the fact that ordinary business shipments were received 
as usual, or at most were fumigated before leaving the 
infected locality. The United States postal authorities 
refused to fumigate the mails and no harm came of the 
omission. 

On the other hand, some places became infected which 
had tried the non-intercourse or shot-gun quarantine born 
of ignorance and panic. Xo land quarantine can be 
absolute; every avenue can not be guarded adequately. 
The stricter the quarantine the more object there is in 
evading it and the more aj)t is the evasion to be success- 
ful ; also the average quarantine is apt to be put on, in 
these days of rapid and easy communication only after 
people have scattered from the point of original infection, 
some of them perhaps to the quarantining i)lace which is 
lulled into a sense of false security because it has put up 
the bars against the rest of the world. 

We have learned that the only sensible restrictions are : 
1° Detention, for a sufficient time, of persons coming 
from an infected or suspected point. 2° Fumigation with 
sulphur of any inanimate objects or packages, coming 
from such places, which might by any chance contain 
living mosquitoes, possibly infected. 3° Careful screen- 
ing of trains, steamboats or other means of transijortation 
between infected and non-infected points. 
Prophylaxis in Place. 

It was demonstrated during the prevalence of yellow 
fever in 1905, that a community able and willing to rid 
itself of stegomyia mosquitoes could look upon the in- 
troduction of a case of the disease with equanimity. The 
means of propagation having been disposed of there can 
bo no danger of a spread of the infection and the presence 
of the infected person is no longer a menace to the 
population. 

]\Iorgan City, for instance, its health and municipal 
authorities having been among the early converts to the 
mosquito doctrine, had its cisterns oiled and screened, 
its street gutters liberally treated with Beaumont crude 
oil, and became practically free from the stegomyia. On 



LESSONS TAUGHT BY EPIDEMIC OF 1905 CHASSAIGNAC. 1057 

an important factor in tlie degree of infection and that 
two, if not three, different occasions, patients ill Avith 
yellow fever came into the town from near-by infected 
points and remained during the course of the disease 
without their presence causing any outbreak of the 
pestilence. 

This and analogous experiences make it clear that any 
place, by means of a timely expenditure of energy and 
money, may put into effect prohylactic measures whose 
efficiency can be counted upon. 

Prophylaxis in Person. 

In places where general preventive measures have not 
been attempted or have proved inadequate, individuals 
may do much in the way of personal prophylaxis. 

The screening of buildings or of living rooms and re- 
maining within them from before sunset to after sunrise 
proved of value during 1905. For those who had to 
go about, anointing the face, neck and hands Avith 
pennyroyal, camphor or other pungent substance; the 
systematic use of kid gloves and fans; wearing a wide 
flounce of mosquito netting below the hat brim, in short, 
the avoidance of mosquito bites by all means possible, 
apparently proved of value. 

Hereafter it should be considered the proper thing 
for individuals to carry out prophylactic measures in 
order to re-enforce those instituted by communities or 
municipalities. 

Depopulation of Infected Places. 

The exodus from infected places of a more or less large 
proportion of the population, sometimes by calculation, 
sometimes merely by impulse, showed in 1905 that this 
could be a very useful procedure. 

The moment yellow fever has gained anything of a 
foothold in a community, as many of the non-immunes as 
possible under existing circumstances should be removed 
until such time as general prophylactic measures shall 
have become thoroughly effective. 



1058 augustin's history of yellow fever. 

However, this should be done with system although 
promptly. The refugees should be segregated in a mos- 
quito free camp, train or boat during the period of incu- 
bation of the disease. It has invariably followed when 
people hurriedly left a stricken place that a certain num- 
ber have fallen sick on the road or in a strange place 
where people have been afraid of them, where it has been 
difficult to secure proper attention at the hands of ex- 
perienced persons, and often where the surroundings have 
been unfavorable. By means of the plan just mentioned, 
the few who are unfortunate enough to fall sick are able 
to get immediate and satisfactory attention, thereby secur- 
ing the best chance of recovery, while those remaining 
well are free to start on their journey without a sword of 
Damocles hanging over them. This can save both physical 
suffering and mental anguish. 

Detention Camps. 

What has just been said shows only one of the useful 
purposes served by detention camps. These have proved to 
be of the greatest utility in avoiding onerous restrictions 
upon travel and preventing the paralysis of all business 
depending upon the going of persons in and out of infected 
places. All those whose affairs are important enough to 
warrant their losing a few days during detention are ab^^ 
to continue their peregrinations without additional inter- 
ference or delay. In the past, a larger number have 
been kept away from places infected, suspected or sus- 
ceptible, by the dread of being bottled up indefinitely 
through quarantine than by the fear of the disease itself. 
We have learned how to provide against this risk by 
means of detention camps and how to establish them 
promptly at a reasonable cost for equipment and 
maintenance. 

TJie Great Lesson. 

The epidemic of 1905, and all it meant of financial loss, 
suffering, grief and death, could have been avoided by 
the timely acceptance of the mosquito doctrine and the 
practical application of its principles. As always, the 



LESSONS TAUGHT BY EPIDEMIC OF 1905 CHASSAIGNAC. 1059 

ouna:^ of preventio.n would have been better than the 
pound of cure. Let us hope that this lesson has been 
well learned and has sunk deep. The people of New 
Orleans, of Louisiana, of our Southland, did nobly, a3 
they always do, when confronted by an appalling emer- 
gency ; but, with their mercurialism, will they give proper 
heed to future possibilities now that conditions are normal 
again? 

We must persevere in our study of sanitary problems 
in general and the warfare against mosquitoes in partic- 
ular. Neither is it too early to give serious attention to 
the chances of entrance of bubonic plague, nor premature 
to train our batteries on the rats. A stitch in time saves 
nine times nine. 



1060 

THE WOKK OF THE MEDICAL PEOFESSIOX OF 
NEW OELEANS DURIXG THE EPIDEMIC OF 

190... 

By Louis G. LeBeuf, M. D., Xew Orleans, 

President Orleans Parish Medical Society, 1905; Visiting 
Physician to Charity Hospital, Xew Orleans. 

In September, 1897, a special meeting cf the Orleans 
Parish Medical Society was called to discuss the yelloAV 
fever situation. This meeting was also convened to in- 
struct the younger members of the profession into the 
etiology, symtomalogy and treatment of the disease. The 
conference proved very valuable. Profiting by this ex- 
perience, a similar meeting was called at the cutset of the 
fever in 1905. In calling the meeting to order the Chair- 
man expressed himself in the following words : 

"No experience in my eighteen years of practice ever impressed me 
more forcibly than just such a meeting as this 'held eight years ago 
in the room of this society, called by Dr. John Callan, the then efficient 
President, for the discussion of the same subject. It was also to try 
and educate the new men of our profession who had never seen this 
dreaded disease. At that time we had with us men who told us of just 
such a meeting called nineteen years before, in 1878. We are happy 
to say that most of these men are still with us. These two previous 
meetings, epoch-making as they were, undoubtedly also were the 
saddest occurrences of our corporate existence, and we must hope that 
this will be the last we ever will 'hold for this purpose. Let us trust 
that the work now being done along the line of destruction and pro- 
tection, following the ascertion, belief and dogma on the etiology of 
yellow fever, will mean the turning point cf a new era, the regenera- 
tion from our former abject, hopeless condition to something definite, 
something tangible. 

"Let us remember how we felt twenty-six years ago. Let us remem- 
ber how we felt eig'ht years ago with nothing ahead of us, nothing 
which could be planned, nothing to combat. Prophylaxis in person 
always failed, prophylaxis in place always futile. No measure ever 
controlled the situation; no amount of disinfection ever helped, and 
when the entire truth was told, the only relief which came was \s-"hen 
the frost of November appeared as a Heaven-sent Nemesis to our 



WORK OF THE MEDICAL PROFt SSION, 190 LeBeUF. 1061 

dreadful scourge. To-day the situation is d'.fferent, and though we 
may not succeed entirely in this present campaign, though we may not 
c'Jieck the disease at once (for various causes which will have to be 
told later), we hope to restrict it to some extent, to diminish its too 
extensive spread, and to instill some hope into our municipal fellow- 
citizens, a hope which will mean the regeneration and the rehabilita- 
tion of our dear city to the standard which she cCiould have amongst 
the future great cities of our country. 

"I want to report, besides, that your Advisory Committee has been 
continuously and actively at work since last Saturday night. The 
task has not been the easiest and pleasantest. We will submit a very 
thorough report later w!hen the work is over, and we hope then to 
show you that we have endeavored rigidly to coiiform with the princi 
pies which govern the disinterested, and high ethical standard estab- 
lished by this society. We 'iiave taken part in every conference, in 
every meeting called for the organization of the great work which is 
being tried in this city. One of the members of your society wrote the 
first instructions which were published last Sunday morning to govern 
all households regarding the control of the situation. Another mem- 
ber of the committee helped on a committee of three to plan and organ- 
ize the up-to-date Emergency Screened Hospital, which was placed in 
operation in thirty-six hours. And though their names do not appear 
in print, nearly every important article or medical direction in the 
public press Cias been furnished or revised by your committee. As we 
are still actively at work in the campaign undertaken, we wish merely 
to report this as brief, temporary report until later, when we can give 
you a fuller and final report." 

Though Carlos Finlay had advanced the theory of mos- 
quito dissemination of yellow fever since 1881 at Havana, 
and though the U. S. Army Yellow Fever Commission, 
consisting of Eeed, Carroll, Agromonte and Lazear, had 
made their epoch making experiments in 1900, and Lazear 
had already sealed the truth of the mosquito-infected 
transmission by his martyrdom as a holocaust to the 
proof of his belief, and though we had had the report of 
the Yellow Fever Working Party No. 2, consisting of 
Drs. Pothier and Parker and Prof. Bej^er, with their 
conclusions from their work at Vera Cruz, still our public 
was profoundly ignorant of these scientific discoveries. 
When the first knowledge reached our city of the presence 
Off this dread disease in our midst, there was almost a 
panic — stocks and bonds went begging, a pall seemed to 



1062 AUGUSTIN S HISTORY OF YELLOW FEVER. 

be thrown on all things, a general exodus of those who 
could afford it took place and the commercial interests 
seemed paralyzed. The experience of former years was 
staring the unitiated public in the face. They remem- 
bered the injury to the city commercially, and the thous- 
ands of lives lost in the j)revious epidemics. New Orleans 
was like a rejuvenated city, with the millions spent here 
in public improvements, and the great activity in bus- 
iness and in railroad construction, due to the recognition 
of its wonderful future and prosj)ects from the advantages 
of proximity to the promised Panama Canal South Amer- 
ican trade. Everything showed it to be on the eve of 
great growth and development, so that when the news 
came to us of this epidemic, it was a elreadful catastrophe. 
The public remembered the pitch barrels of 1878, the 
flags and costumes of gruesome attendants in 1897, and 
nearly all were in mourning for some dear friend or 
relative. 

Yellow fever itself, when properly treated or better, 
when properly let alone and nursed, is not such a very 
fatal disease. In the hands of a competent medical at- 
tendant the mortality is not so great as manv other dis- 
eases, but it was the mystery of its onset and the strano'e, 
unaccountable manner of its propagation which chilled 
the heart and struck terror to the bravest. All mankind 
has some innate superstition, and any disease which 
comes in the night, as in this instance stealing from house 
to house, sometimes taking a whole block without cross- 
ing the street, but most times spreading all over like 
wildfire, without any one being able to explain its exact 
cause and mode of transmission, naturally appalled every 
one. 

This was the condition of affairs when this campaign 
opened, and this v>'as thp st^^to of thir'zs vrhen, on July 
22nd, we were told publicly of this trouble. Xo dir- 
tressed people ever found its medical profession more 
united and more willing to help iban cvts was on that 
date. There was a tremerdoun vxi-k ahead of us, the 
work of education, of teaching tl e new belief and the 
training in the great campaign cf pre plni axis and de- 



WORK OF THE MEDICAL PROFESSION, 1905 LeBuEF. 1063 

struction, the tliousands of laymen who were willing to 
make the good fight. Our part was the important one, 
and the difficult one; it is not very easy to reform the 
uninitiated to new ideas; ignorance is generally self- 
satisfied and prejudiced, and the propagandist of the new 
theory and of the ncAv scientific facts has to prove his 
contention before it is believed. 

It was not all to tell the public of the established facts 
of Los Animas and Vera Cruz; we were forced to start 
a campaign of education and forced to labor on the front 
line to direct the work of destruction and prevention. 

The old theory of fomites and infection was over, and 
the simple fact that, first, a mosquito, and the female 
Stegomyia Galopus at that {fasciata as it was caL^ea 
then) was the offender; secondly, it could transmit the 
disease only if it was allowed to bite a yellow fever 
patient during the first three days of illness ; thirdly, and 
lastly, that this yellow fever infected mosquito could not 
reproduce the disease before about twelve days after its 
inoculation or injection. 

So, starting from these three basic fundamental truths, 
three specific lessons had to be taught, and practiced as 
the very catechism and Bible of our entire conduct. 

(a) Enforce the protection of the yellow fever patients 
from the bite of all mosquitoes, to exclude the special 
offender ; i. e., provide mosquito bars and screen the room 
of the patient at once. 

(b) This work of screening had to be performed as 
early as possible to prevent infected mosquitoes from 
escaping and propagating the disease. 

(c) The final destruction of all the mosquitoes which 
might have j)erchance bitten a case, before the twelve 
days of incubation or digestive preparation was completed 
in the salivary glands or digestive tract of the insect and 
thus rendered it dangerous to other human beings. 

Though these three simple truths were plain and easy, 
it was only the starting point of the great educational 
fight the medical profession had ahead of it. To be more 
certain of our success, it was wiser to destroy all the mos- 



1064- augustin's history of ynllow fever. 

quitoes we could, both directly by general fumigation, 
and also by diminishing the probable sources of their 
habitat. 

Screening, sagging gutters of roofs, barrels, water con- 
tainers or any stationary yehicle where larvae might be 
hatched — this was the dogma and instruction we had to 
disseminate. If we were successful, though we might not 
be able to stop the disease, as we had been informed of it 
too late, and for various inexplicable reasons the fact of 
the presence here had been unrecognized, or if recognized 
had been through criminal neglect and blindness allowed 
to spread beyond control, we would possibly, with a good 
fight, be able to restrain its too great spread, and prove 
to the world by this restriction that we could do some- 
thing that would affect its unlimited spread, and therefore 
re-establish confidence and build for our future an assur- 
ance of action and control which would allow us to throw 
off our chains and fetters, and forever prove cur immunity 
from what we could henceforth call the Mosquito Fever, 
instead of the awe-instilling name of Yellow Fever. 

As a good deal of the following history Avhich must be 
related personally refers to the work of the Advisory Com- 
mittee of the Orleans Parish Medical Society, of which 
the present writer was Chairman, I will take the liberty, 
in most of the remainder of this article, to give excerpts 
ot reports written by Drs. Sidney L. Theard, the ablei 
Secretary of the City Board of Health; Prof. Kupert 
Boyce, Dean of the Liverpool School of Tropical Medi- 
cine; Reverend Beverly Warner, in charge of the Citizens' 
Educational Campaign, and the 1905 Annual Report of 
the Orleans Parish Medical Society: 

The First Steps in the Campaign and the Organization 
of the Resources of the City to Comltat the Disease. 

On Friday, July 21st, a meeting of the State and City 
Boards of Health, the representatives of the Public 
Health and Marine Hospital Service, and Health Officer^ 
from surrounding States with Drs. LeBeuf and Magruder, 
was convened in order to reassure the public and to 



WORK OF THE MfcDICAL PROFESSION, IJ-OS LkBeuF. 1065 

check the stringent and onerous quarantine precautions 
which had, on the rumors of the presence of yellow fever, 
been promptly taken by the surrounding States against 
New Orleans, although as yet no official declaration had 
been made. As an example of this promptitude, it is 
worthy of note that the State of Mississippi had issued 
a quarantine ordinance on the day of the meeting. 
Shortly after the meeting on Friday the first step in gen- 
eral medical organization was taken by the appointment 
on the following day, July 22nd, of an Advisor}^ Board, 
consisting of the Chairman, Dr. Louis LeBeuf and three 
other members of the Orleans Parish Medical Society, 
viz., Drs. John Callan, Marcus J. Magruder and John F. 
Oechsner. This Committee was appointed to coi-operate 
with the health authorities and to help to the best of their 
judgment in the campaign ahead of them. It was now 
fully recognized by these representative medical men that 
much valuable time had already been lost, and that the 
prophylactic measures which had up to this time been 
adopted by the health authorities were neither sufficiently 
extensive nor precise. The failure of New Orleans in this 
respect emphasizes what every Internationa] Sanitary 
Convention had drawn attention to, namely, the necessity 
of prompt notification of yellow fever. Without this, in- 
ternational and interstate laws of sanitation can not be 
administered with science, wisely and humanely. 

On the evening of July 22nd, the Advisory Committee, 
the Medical Health Officer and Dr. J. H. White, U. S. 
Marine Hospital Service, after a protracted consultation, 
issued the first authoritative and collective pronounce- 
ment upon the precautions which were necessary to be 
adopted. The manifesto reads as follows : 

An emergency exists in our city which demands the attention of 
every individual, with the view to limiting and preventing the spread 
of epidemic disease. It has been scientifically proved that the mosquito 
is the only means of the transmission of Yellow Fever. Measures 
s'hould he especially directed against them. It is especially urged by 
the undersigned that the following simple directions be followed by 
the householders of this city during the summer months: 



1066 augustin's history of yellow fkver. 

First — Empt}^ all unused receptacles of water. Allow no stagnant 
water en the premises. 

Second — Screen cisterns, after placing a small quantity of insurance 
oil (a teacupful in each cistern) on the surface of the water. 

Third — Place a small quantity of insurance oil in cesspools or privy 
vaults. 

Fourth — Sleep under mosquito nets. 

Fift'h — Screen doors and windows wherever possible with fine mesh 
wire. 

(Signed) QUITMAN KOHNKE, 

Health Officer. 
J. H. ^\^^ITE, 

Surgeon, U. P. H. and M. H. S. 
ADVISORY COMMITTEE, 

O. P. M. S. 

Ou the same day (July 22) the authorities, realizing 
that Xew Orleans was unprcYided with a Fever Isolation 
Hospital, took steps to acquire an old house in the in- 
fected quarter in the Italian district. It seems, of course, 
very extraordinary that in the twentieth century, and in 
a port of the great importance and size of New Orleans, 
that no proper provision should have existed for the isola- 
tion of infectious cases. There is no doubt, however, 
after having paid dearly for their experience, that the 
Citizens of Xew Orleans will not in future allow this 
defect to go unremedied. 

The Hospital received its first patients on July 26th, 
and in spite of the fact that it v;as placed in the midst 
of most unsanitary surroundings and overcrowded, it, 
nevertheless, answered its purpose very well, ovring to 
the very rigid precautions against the possibilities of 
mosquitoes becoming infected from the patients. It was, 
indeed, a most striking demonstration of the harmlessness 
of the disease in the absence of the Stegomyia; seven non- 
immunes, including myself, spent a portion of each day 
in the wards, but in no instance did infection arise. The 
entrance to all the wards was barred by double screened 
doors, so that one set of dcJors were closed before the 
second set were opened. 

A few weeks after the opening of this Hospital, it be- 
came necessarv to change into another temporary make- 
shift. 



WORK OF THE MEDICAL PROFESSION, 1905 'LeBeUF. 106? 

The new premises were larger, more airy and situated 
amongst more sanitary surroundings. Owing to the sub- 
sidence of the fever, it had, however, far less work to do 
than the former. There is no doubt that the emergency 
hospitals did magnificent service, and that the greatest 
credit was due to Dr. Hamilton P. Jones, Dr. Paul Emile 
Archinard, Dr. J. Birney Guthrie, and to those who as- 
sisted them in the most arduous and difficult task, ren- 
dered still more trying owing to the hostile attitude of 
the poorer classes of Sicilians and Italians. 

Simultaneously Avith the formation of the Medical 
Advisory Board, a meeting was held in the City Hall, 
under the auspices of the Mayor, the State and City 
Health Officers, and a number of citizens prominent in 
business and professional life, to review the fever situa- 
tion and to raise money. The outcome of the meeting 
was the successful launching, under the chairmanship of 
Mr. Charles Janvier, of a Finance Committee — The Citi- 
zens' Yellow P^ever Fund Committee — for the purpose of 
collecting funds to carry on the fight against the fever. 
On Sunday, July 23rd, the Eeverend Dr. Beverlv Warner, 
from his pulpit, took the first step in Anti-Yellow Fever 
propaganclism amongst religious denominations, and on 
Monday, July 24th, the Fourteentih Ward of the City 
organized anel met for the purpose of cleaning up and 
screening its own district, and for authority to issue an 
advertisement ''For bids to screen its 250 cisterns with 
copper gauze or cheese cloth, and for tenders to clean 
out the drains." All present at this meeting subscribed 
to the Ward Funds. Its example was immediatelv fol- 
lowed by the other wards, and thus we started the Ward 
Organization, which was subsequently placed under the 
direction of Dr. Warner. 

It will now be simple to trace the steps in the campaign 
if I follow the work of the several organizations : 

1. The Local Medical Organization. 

2. The Warel Oroanization. 

3. The Public Health and Marine Hospital Service 

Organization. 

4. The Educational and Press Organization. 

5. The Financial Organization. 



106 5 augustin's history of yellow fever. 

THE LOCAL MEDICAL ORGANIZATION. 

Appeal foi^ Civic Co-operation. 

On Monday, July 24th, 1905, a proclamation was issued, 
signed by the Mayor and concurred in by the Medical 
Authorities, setting forth the situation, and calling upon 
the citizens to co-operate with the Health Authorities in 
stamping out the fever. It read as follows: 

Mayoral'ty of New Orleans, 
City Hall, July 24tli, 1905. 
To the People of New Orleans: 

The Health situation in this city is serious, but not alarming. Be- 
cause of this situation, quarantine has been declared against New 
Orleans by several States and Cities. It is proper that the actual 
facts be recognized and dealt with resolutely and calmly. 

It is authoritatively stated by eminent sanitarians that within 
recent years visitation of Yellow Fever, more widely spread than that 
which is in our City, have been successfully met and absolutely 
suppressed by methods whose potency has been demonstrated by as- 
certained results, and the application of which is simple. T'liose 
methods are now adopted by our own State and City Health Authori- 
ties, with the volunteer assistance of the United States Marine 
Hospital Service, and the Orleans Parish Medical Society of this 
Parish. To the perfect and speedy success of the measures to be 
followed, the co-operation of every householder is necessary. That 
given, the people may confidently expect a speedy release from the 
trying conditions in which they are now placed, and from the appre- 
hension of its recurrence in the future, 

I, therefore, as Mayor, urge all citizens and householders to render 
cordial and ready obedience to the instructions which may from time 
to time be given ^y the Healt^a Authorities!, and to render every aid 
within their powei' to those Authorities in the earnest efforts which 
they are now making, and in which they will persist for the absolute 
stamping out of this infection. These instructions are not difficult of 
performance; tHiey are easily to be understood, and can be followed 
with but little expense. Since the consensus of sanitary and medical 
opinion of to-day is that the infection of Yellow Fever is transmitted, 
or can be transmitted, only by means of the sting of the insect known 
as the "cistern mosquito," the following advice recently given by Dr. 
Kohnke, the City Health Ofllce; by Dr. Souchon, President of the 
State Board of Health; Dr. White, Surgeon of t'ie United States Marine 



WORK OF THE Mi<;DICAL PROFESSION, 1905 — LkBeUF. 1 0G9 

Hospital Service, and an Advisory Committee of the Orleans Parish 
Medical Society, should be willingly and implicitly obeyed by every 
householder in this city: 

First. — To keep empty all unused receptacles of water in every 
house, and allow no stagnant water on any premises. 

Second. — To screen all cisterns after placing a small quantity of in- 
surance oil (a teacupful in each cistern) on the surface of the water. 
Third. — To place a small quantity of insurance oil in cesspools or 
privy vaults. 

Fourth. — Sleep under mosquito nets. 

Fifth. — Wherever practicable, screen doors and windows with wire 
screens of close mesh. 

The foregoing advice may from time to time be given by the Health 
Authorities with more particularity. Whatever emanates from them 
must be accepted as given for the good of the city and the preserva- 
tion of every individual of its population, and should be respected and 
followed to the letter. 

I repeat, upon the information cf t'aose qualified from actual investi- 
gation and scientific knowledge to speak upon this subject, that the 
situation in our city is not alarming, and that if it is treated by our 
people earnestly and intelligently, that this situation will soon be 
eliminated and demonstration will be made to the world that for the 
future the infection cf Yellow Fever can have no permanent lodgement 
within the borders of the city of New Orleans. 

MARTIN BEHRMAN, Mayor. 
We concur in t'ae above. 

QUITMAN KOHNKE, 

City Health Officer. 
EDMOND SOUCHON, M. D., 

President, L. S. B. H. 
J. H. WHITE, 
Surgeon, P. H. and Marine Hospital Service. 
ADVISORY COMMITTEE, 
Representing Orleans Parish Medical Society. 

II. APPEAL FOR EAELY NOTIFICATION. 

On July 2Itli, 1905, a most important notice was also 
issued to the members of the Medical Profession from the 
Orleans Parish Medical Society, and signed by the Ad- 
visory Committee, Dr. White, U. S. P. H. & M. JS. S., and 
the President of the Louisiana State Board of Health 
urging upon each medical man the absolute necessity of 



1070 augustin's history of vellc.w fever. 

early notification and of reporting all cases of fever. It 
is unquestionably an exceptionally wise circular and 
touches a very weak spot. I reproduce it : 

Orleans Parisli Medical Society, 

New Orleans, La., July 24, 1905. 

Dear Doctor: — ^We want to specially urge you to report all your 
cases of fever — malarial, typhoid or fever of any kind — during this 
summer, to the City Board of Health. It is absolutely essential to the 
checking of the spread of Yellow Fever in our city that all cases of 
fever sCiould be promptly and conscientiously reported. Our patients, 
the public and the surrounding communities, will naturally look to our 
profession in this great emergency, and the responsibility rests in a 
great measure with us to check this condition, or at least to limit its 
too extensive spread. It is a well known and scientifically proven 
dogma that the mosquito theory is to be accepted as a fact; then we 
must exert ourselves to the utmost to destroy the mosquito, the only 
host of transmission of Yellow Fever. Let us, tiien, make a consis- 
tent campaign against it, educate our patients regarding this situa- 
tion and the danger of it, and direct them to place patients immediate- 
ly under netting pending action of the Board of Health. Neither your 
patient nor the household will be subjected to the obnoxious house 
quarantine of several years ago. 

Above all things, report your cases promptly, to permit us to check 
any further foci of infection. 

Even if you are not positive tJhat the mosquito is the only source of 
transmission of Yellow Fever, give your city the benefit of the doubt 
in this important and vital matter. , 

Respectfully, 

EDMOND SOUCHON, M. D., 
President Louisiana State Board of Health. 

QUITMAN KOHNKE, M. D., 
Health Ofiicer of the City of New Orleans. 
J. H. ^TIITE, M. D., 
Surgeon, U. S. Public Health and Marine Hospital Service, in charge 
of the Government Measures. 

JOHN CALLAN, M. D., 
J. F. OECHSNER, M. D. 
M. J. MAGRUDER, M. D., 
L. G. LeBeuf, M. D., Chairman, 
Advisory Committee, Orleans Parish Medical Society. 



W*.RK OF THE MKDICAL PROFESSION, 190' LeBeUF. I 07 I 

III. APPEAL FOR IMMEDIATE SCREENING OF 
SUSPECTED CASES AND FUMIGATION. 

This circular was immediatelT followed by another to 
the medical men, again urging the importance of early 
notification and careful fumigation. As regards the 
method of fumigation the circular is not as stringent on 
this subject as subsequent experience found to be abso- 
lutely necessary to ensure safety: 

Orleans Parish Medical Society, 

New Orleans, La. 

Dear Doctor: — In an earnest attempt to work in harmony with the 
plan of procedure adopted 'by the Healtih Authority, and the U. S. 
Public Health and Marine Hospital Service, now being enforced in a 
general inspection of our entire city, we want to suggest to you, as 
your Advisory Committee acting with these bodies, that you report at 
once any case of fever in your practice remotely suspicious of being 
Yellow Fever. If you want to do your city the greatest good in this 
hour of trial, immediately constitute yourself as a Health Officer for 
the premises of the sick you are called to attend.' Even before the 
regular Sanitary Inspector of the Board reaches the Ciouse, place the 
patient at once under a mosqulio bar, pending further proceedings. 
Also order at once another loom fumigated with sulphur — 2 pounds 
to the 1,000 cubic feet — and then thoroughly scieen it. Ii it cann'st 
be done in a perfect manner at least order all the openings screened 
with either cheese c'ot'h or other light material, well packed so a.^, to 
allow no mosquitoes in the room. Keep only one door free, covering 
all the transoms in the same manner. On entering this door beat the 
air thoroughly with a cloth before opening. When the room is pre- 
pared, remove the patient to it, fumigating the room just vacated in 
the same manner. 

After the first three days of the fever the Stegomyia fasciata cannot 
be infected from that patient, but we must be careful to keep the room 
well closed until the final fumigation or destruction of any mosquitoes 
which might have remained in the room. Look to the general hygiene 
of the house, inquire whether the cirterns or any other open receptacles 
of standing water about the premises have been properly oiled or 
screened. Act in this matter regardless of the worn: which will be 
done by the constituted authorities, for your own personal good and 
for the greatest good of your city. In other words, Doctor, 
take every possible precaution to protect all of your fever cases from 
being bitten by mosquitoes during the first three days of fever. 



1072 augustin's history of yellow fever. 

Our interest in the entire matter is the same as yours, and we must 
work for the same purpose. The part to be played by our profession 
i& an extremely important one; the faith and trust of the entire com- 
munity is placed on our shoulders, and we must fully deserve fhe con- 
fidence reposed in us. 

Very sincerely yours, 
ADVISORY COMMITTEE, Orleans Parish Medical Society. 

IV. APPEAL FOR AN EDUCATIONAL CAMPAIGN. 

Another circular was issued on July 24tli, 1905, directed 
to the Board of Health, pointing out the necessity of a 
Campaign of Education, and urging the importance of 
asking the Clergy to especially disseminate knowledge 
from the pulpit in the matter of yellow fever. The cir- 
cular then proceeds to give useful information in case 
of infection, and finally appeals for united action in a 
general warfare against the Stegomyia: 

Orleans Parish Medical Society, 
New Orleans, July 24th, 1905. 

Gentlemen: — ^The condition, existing at present is one that calls for 
the most strenuous, prompt and vigorous measures capable of institu- 
tion. In view of the absence of the necessity for obnoxious local or 
house quarantine, the co-operation of physician and householder should 
be a matter of comparatively easy solution. A campaign of education 
s'hould be boldly inaugurated. The clergyman, during his rounds and 
from his pulpit, should be a valuable agent in the dissemination of 
this knowledge. The Advisory Committee of the Orleans Parish 
Medical Society begs to recommend that the following measures be 
instituted at once, with the view of stamping out the few foci of in- 
fection of Yellow Fever which now exists in our city: 

Cases of fever of any character developing in the infected area may 
be regarded as suspicious, and the patient immediately protected from 
mosquitoes. The house, cisterns, yards, drains, gutters, cesspools and 
vaults should be carefully inspected, and no breeding spots for 
mosquitoes should be overlooked. 

The gutters and streets must be carefully inspected, and no breed- 
ing spots for mosquitoes should be overlooked. 

The gutters and streets must not be neglected. If the case proves 
to be one of Yellow Fever, the house must be screened and the rooms 
in the house ot'her than the one occupied by the patient must be 
fumigated to destroy all mosquitoes in them. When the case ends, 
either by recovery or death, the room occupied by the patient must 
be fumigated, for the same reason. 



WORK OF THE MEDICAL PROFESSION, 1905 Lb BeuF. 1073 

The success of these procedures will largely depend upon the 
promptness and earnestness with w'hich mosquitoes are prevented 
from coming in contact with the patient and the destriction of all 
mosquitoes in the room after the patient is cured or dies. 

The new foci of infection must be diligently sought and drastic 
measures adopted for stamping them out. It is only through the pro- 
per conciliatory education of the physician and t'he layman, and 
through their sincere co-operation, that anything can be accomplished. 

For the vast portion of the city not infected, we recommend that a 
sufficiently large force of men be immediately organized to place oil 
in all unscreened cisterns, or other breeding places of mosquitoes, 
and distribute circulars among householders enlisting tlheir co-opera- 
tion. All gutters should either be flushed or oiled. 

An active, vigorous and persistent warfare on mosquitoes should, in 
our opinion, be immediately instituted from one end of the city to 
the other, as in this way localities now healthy may be kept so, even 
though foci of infection be introduced. We believed t'hat the sanitary 
regeneration of this city depends entirely upon prompt and vigorous 
action upon your part,. 

With the profoundest assurances of our heartiest co-operation with 
jou in any movement to better the sanitary conditions of the city. 

We beg to subscribe ourselves, 

ADVISORY COMMITTEE, Orleans Parish Medical Society. 

V. A WAENING TO BEWARE OF THE DANGER 

OF OVERLOOKING THE LESS OBVIOUS 

BREEDING PLAGES OF THE STEGOMYIA. 

A very useful and practicaL notice was also sent out 
by the Advisory Committee, directing attention to the 
importance of not overlooking possible receptacles of 
water in the house, as pitchers, flower-pots, etc. It reads 

us follows : ' 

Orleans Parish Medical Society, 

New Orleans, Louisiana. 
We desire to call your attention to the wrigglers seen inside of the 
■residence of people. Probably the public in the fight against fhe 
mosquito have directed all their efforts against the cisterns and the 
i)arrels or the outside containers, still a source of great danger also 
exists inside of the bedrooms in the water-pitchers, in the dining- 
room, or in the conservatory in the water-pots, vases or' pots" for 
plants. A frequent error and a great menace is t'he habit which sonie 
liouseholders have of only partly emptying a water-pitcher, and though 



1074 AUGUSTIN S HISTORY OF YELLOW FEVER. 

it is refilled daily it is never entirely emptied, leading always one-half 
pint or so for the larvae to develop. Any physician in his daily rounds 
can see this illustrated by inspecting the various water-pitchers in 
the bedrooms. 

On this same line we heg to again call your attention to the accumu- 
lation of water in the urns of the cemeteries, as well as in the sagged 
gutters of the house drains, which are a great source of mosquito 
breeding after rain. 

YI. APPEAL FOE A MOEE SKILLED MEDICAL 
BODY TO CONDUCT THE CAMPAIGN. 

On August the 4th, the fever still making headway in 
spite of all local efforts, the AdvisorT Board took very 
decided action. It candidly expressed the opinion that 
it had not confidence in the efficacy of the work performed 
up-to-date; THAT THIS WOEK MUST BE ABSO- 
LUTELY PEEFECT IN ITS WOEKINO TO BE EFFL 
CIENT, and to accomi^lish the desired re-organization it 
was necessary to call in the assistance of the Public 
Health and Marine Hospital Service of the L^nited States : 

Orleans Parish Medical Society, 
New Orleans, La., August 4th, 1905. 
City Board of Health, 

New Orleans: 

As there has appeared a new case in the Frj'e focus, which has been 
in existence since Monday, while we had been told that the instruc- 
tions previously agreed upon in the management of all maturing foci 
had been rigidly carried out, and especially so in this case. As we 
are not satisfied that the fumigation performed by the City Board of 
Health has been absolutely effective, we feel, as we have shared some 
of the responsibility of this work, and that it is a matter of too great 
importance to be kept on in this unorganized and unsystematic 
manner. This is the first serious visitation of Yellow Fever in this 
country since the mosquito has been recognized as the only mode of 
transmission, and we are unwilling to support the City Board of 
Health in what we consider an ineffective service. 

We regard this as the first crucial test in America, and it must be 
absolutely perfect in its working to be eflicient. We think that the 
community has lost confidence in this work. We know the profession 
has lost faith in it. Hence, we cannot keep on upholding a system in 
which we do not fully concur, so we desire to strongly recommend 



WORK OF THE MEDICAL PROFESSION, 1905 Le BeUF. 1075 

that the system be completely reorganized, or that the entire Yellow 
Fever situation in New Orleans be placed in the absolute control of 
the United States Public Health and Marine Hospital Service. 
Very respectfully yours, 
ADVISORY COMMITTEE, Orleans Parish Medical Society. 

As a result of this letter and of a telegram despatched 
to the President of the United States, the Public Health 
and Marine Hospital Service assumed, in a few days^ 
assumed control of the campaign. The Advisory Com- 
mittee, however, continued their useful work and co- 
operated with the new forces under Dr. White, just as 
they had done with the Local Health Authorities, con- 
tinuing to issue, with the advice of Dr. White, most 
useful circulars, and to generally encourage in every way 
the citizens to keep up the fight with unabated vigor. As 
the circulars which they issued show a thorough knowl- 
edoe of the situation and great foresight, I gave them in 
full. 

VII. LETTEK WAENING MEDICAL MEN NOT TO 

OVEKLOOK THE MILD TYPE OF YELLOW 

FEVEE WHICH MAY BE FOUND IN 

THE NATIVE BORN. 

Orleans Parish Medical Society, 
New Orleans, La., August 17th, 1905. 

Dear Doctor: — In the consistent campaign we are now waging 
throughout the city against the fever we want to enlist your hearty 
assistance. 

We have shown up to now a uniform activity, and if some of the 
work already accomplished begins to show some little improvement, 
we feel it is greatly due to your co-operation. This, though, is the 
crucial moment and you must keep up reporting all your cases with 
unfailing promptness. THE NATIVE BORN WILL UNDOUBTEDLY 
BEGIN TO BE AFFECTED, AND WILL SHOW THE LIGHTEST AND 
MILDEST TYPES OF THE DISEASE; IT IS SPECIALLY WITH RE- 
GARD TO THESE THAT WE WISH TO WARN YOU, FOR IT IS AS 
IMPORTANT TO THE SUCCESS OF THE WORK BEING DONE BY 
THE U. S. P. H. AND MARINE HOSPITAL SERVICE THAT THE 
MILD CASES BE REPORTED AS WELL AS THE MARKED CASES. 
THESE MUST BE SCREENED AS CAREFULLY AS OTHERS. 



1076 augustin's history of yellow fever. 

' One stegoniyia infected, in tlie first tiiree days from such a case, 
can produce a number of serious and even fatal cases. TJie means 
employed are being systematized and rendered less objectionable 
daily by tlie service, so let us endure a little inconvenience for tbe 
welfare of all, 

Beware of the so-called immunization or acclimatization fever and 
report these cases as promptly and rigidly as if they were perfectly 
characteristic, so that the authorities will be able to give them the 
same sanitary treatment. 

Very earnestly yours, 
ADA^ISORY COMMITTEE, Orleans Parish Medical Society. 

Till. APPEAL TO HOUSEHOLDEES TO DELAY 

"M0YI:N^G DAY" OX ACCOLXT OF DAXGEE 

OF SPEEADIXG IXFECTIOX. 

In view of the near approach of "Moving Day" (October 1st) the 
undersigned deem it their duty to direct your attention lo the danger 
likelv to attend a general moving of tenants from house l j house. 

Persons moving from infected localities may later iles^'jlop the ;ever 
in uninfected neighborhoods, thereby developing new ro . i. Others now 
residing in uninfected houses may contract the disease by removing 
into houses where mild cases of fever may have occurred and re- 
covered without medical attention, and consequently escaping fumifa- 
tion. Non-immunes coming into such houses will almost ineviiably 
contract Yellow Fever, thereby adding to our present troubles. 

We do therefore urge the importance of taking such steps as may 
be necessary to delay the general movement for at least thirty days. 
ADVISORY COMMITTEE, Orleans Parish Medical Society. 

IX. DAXGEE OF EE:\I0YAL OF TEMPOEAEY 
CISTEEN SCEEEXS. 

Orleans Parish Medical Society, 
New Orleans, La., September 13, 1905. 
There being a pretty general understanding in the community that 
the cheese-cloth screens over cisterns have to be removed hy October 
1, and the regular IS-mesh to the inch wire screen substituted by that 
date, we believe that a number of persons are now having this change 
done to the great danger of a general liberation of all mosquitoes im- 
prisoned or bred from the pupae in the cisterns. We cannot afford, 
in the final fight of checking Yellow Fever in our midst, to neglect so 
important a matter as this, so we strongly urge that the change from 



WORK OF THE MEDICAL PROFESSION, 1S05 LeBeUF. 1077 

c^heese-cloth to wire, if not legally postponed until December 1, shall 
be by having the wire screen placed over the cheese-cloth without re- 
moving the latter. 

ADVISORY COMMITTEE, Orleans Parish Medical Society. 

Besides all this work, the Orleans Parish Medical 
Society issued seven thousand pamphlets of directions 
and instructions to the medical profession and the trained 
nurses of the entire South. These pamphlets were sent 
broadcast at the expense of the Treasury Department of 
the United States. The contents of these pamphlets were 
carefulh^ written by Dr. Eudolph Matas, and were 
approved by the Society as an exact clinical and pro> 
phylactic treatise of the entire yellow fever treatment. 

In conclusion, let me add that the hard-worked pro- 
fession of New Orleans never demurred when called upon 
to do its duty in the repression of the epidemic. The fol- 
lowing able j)hyGicians lectured ?nd demonstrated the 
propaganda of sanitary and hygenic rules in every corner 
of the city; from the pulpit of churches and synagogues 
to the factories on the river front ; from the negro meeting 
houses back of town to the school houses on the front of 
the city. Yes, and further still, many were called out to 
speak in country places as far as Opelousas and Mer 
Kouge, at their own expense, and at great sacrifice to their 
practice. Amongst a list of volunteers, I wish to name 
those that come to m^^ mind at this moment : 

Dr. Juan Guiteras, from Havana; Sir Rupert Boyce, 
Dean of the Liverpool School of Tropical Medicine, from 
England — two experts, as distinguished volunteers in our 
cause ; Dr. Quitman Kohnke, whose Lantern Slide demon- 
strations were most conclusive and interesting; Dr. Bev- 
erly Warner; Dr. O. L. Pothier; Dr. Allan Eustis; Dr. 
P. E. Archinard; Dr. Clias. Chassaignac; Dr. J. H. White; 
Dr. J. A. Storck; Dr. Henry D. Bruns; Dr. H. B. Gess- 
ner; Dr. S. L. Theard; Dr. John Callan; Dr. J. B. Guthrie; 
Dr. E. D. Martin; Dr. M. J. Magruder; Dr. John F. 
Oechsner; Dr. E. L. McGehee and Dr. Jos. Holt. 



1078 

STATISTICAL EEVIEW OF THE YELLOW FEVEE 
EPIDEMIC OF 1905, NEW OELEANS. 

BY JULES LAZARD, M. D.^ NEW ORLEANS, 

Statistician of the Yellow Fever Campaign , New Orleans^ 
1905, U. S. Fiihlic Health and Marine Hospital Service. 

General E em arks. 

In epidemics of all diseases, reference is always made 
to the prerions visit of the disease in a commnnity. Dur- 
ing the epidemic of 1905 in ]N^ew Orleans, the table of the 
epidemic of 1878 was used in studying the progress of 
the disease, as this epidemic resembled the one of 1905, 
only that the latter began earlier in the year and for that 
reason it was prognosticated that it would be more severe, 
a j)rophecy not borne out by later results. 

Because of the use made of the figures of 1878, which 
were inaccurate and fragmentary, it was deemed advis- 
able to place in a compact, intelligent and accurate form, 
the figures of 1905. The writer is quite aware that figures 
are very dry and uninteresting, unless some point is to 
be illustrated or proved. 

New Orleans succeeded very well tor a number of years 
in keeping yellow fever out by maintaining a maritime 
quarantine and an inspection system against the Tropics. 
This system succeeded very well from 1898 to 1905, but 
^'the best laid schemes of mice an' men,-- etc. It was in 
no position, however, to successfully combat the disease 
once it entered the community, except by some gigantic 
movement, entailing the labor of many men and the ex- 
penditure of much money. Much time is lost in training 
men, physicians, fumigators and laborers before the force 
<^an work intelligently. It was clearly seen in 1905 that 
the success of a fight against an epidemic depended abso- 
lutely upon organization and equipment. 

Good and bad are difeerent sides of the same picture. 
The entrv of the disease in 1897, with a slight reappear- 
ance the 'following year, taught New Orleans the inefiflci- 



STATISTICAL REVIEW, 1905 LAZARD. 1079 

encT of lier archaic sewerage sj^stem and her poor^ poor 
water supply s^^stem, though she was on the banks of the 
world's greatest river, flowing the purest water. 

The visitations of yellow fever above noted gave New 
Orleans suggestion for a change in these important sys- 
tems of a municipality. In 1897 and 1898, the mosquito 
doctrine was not fully known, or not known at all, but 
the helplessness of the city and the fervent prayers for 
an early frost, clearly indicated that something of a most 
radical sort must be done, if ever this disease made its 
entry again. A new drainage and water system was voted 
and passed upon. This was the good side of the picture 
of the epidemics of 1897 and 1898. Otherwise there is 
no telling how long the city would have delayed in insti- 
tuting these sanitary reforms. 

With a free supply of water, cisterns^ — vats for collect- 
ing and retaining rain water from roofs — will soon be 
torn down by order of the law, unless the ^Taxpayers' 
Association" is stronger in its opposition than it seems 
to be. This will rid the city of the greatest breeding 
places of the Stegomjjia fasciata or calopus, or whatever 
we may presently decide to call the mosquito which has 
cost the South so many thousands of lives and such vast 
sums of money. 

On July 21,^ 1905, a quarantine was declared against 
New Orleans by the neighboring states. There is no way 
by which it can be definitely stated when the first case 
appeared in this city. This is always a difficult matter. 
Below are some deaths taken from all sources — the records 
of the City Board of Health, Charity Hospital, Touro 
Infirmary, Hotel Dieu. It is conceded by all who watched 
the progress of the disease that it began in the ^^Infected 
District," an area from the Mississippi River to the wood 
side of Bourbon Street and the lower side of St. Ann to 
the upper side of Esplanade Avenue — the ''Little Italy'* 
of New Orleans, an area covering twenty-four squares. 

Here is the record : 

"SUSPICIOUS" DEATHS, 1905, PREVIOUS TO EPIDEiMIC PERIOD. 

June 19 — L. M., 'Italian, aged 51 — ^Chronic nephritis and aortic aneurism. 
June 20— L. K., Austrian, aged 28— Malarial remittent fever. 



1080 AUGUSTIN'S HISTORY OE YELLOW FEVER. 

June 23 — I. B., Italian, aged 28 — ^Malarial fever. 

July 1 — A. S., Italian, aged 40 — Endocarditis, 1118 Grallatin. 

July 2 — ^J. M., Italian, aged 14 — Continued fever. 1118 Gallatin. 

July 3 — diV., Italian, aged 2^Typ'hoid fever. 1118 Gallatin. 

July '9 — S. A., Italian, aged 24 — Malarial Taxemia, 520 St. PMlip. 

July 10-^G. v., Italian, aged 65--Gastric Cancer, 528 St. Philip. 

July 12— F. S., Italian, aged 28— Ac. par. Nephritis, 1021 Decatur. 

July 12 — A. L., Italian, aged 26 — ^Hemorrhagic fever, 1039 Decatur. 

July 12 — F., La., aged 16 — Febris Hemorrhagica, 1028 Ghartres. 

July 13— G. G., Italian, aged 32— Chr. Par. Nephritis, 528 St. Philip. 

July 17— F. S., Italian, aged 30— Typhoid, 1026 Chartres. 

July 17 — ^L. G., nationality not given, aged 45 — ^Alcoholism, 1105 N. 

Peters. 
July 17 — J. S., Italian, aged 52 — Malarial fever, 1107 Decatur. 
July 17 — F. S., Italian, aged 45 — Pneumonia, 605 St. Philip. 
July 17^G. T., Italian, aged 46— Typhoid, 528 St. Philip. 
July 17 — J. E. A., nationality not given, aged 1 — ^Pertussis and Cong. 

of the brain, 1127 N. Peters. 
July 17 — J. M., Italian, aged 14 — Continued fever, 528 St. Philip. 
July 17— S. R., Italian, aged 22— Typhoid, 1123 N. Peters. 
July 18— J. G, Italian, aged 47— Typhoid, 1113 Chartres. 
July 18— Di S., aged 30— Typhoid, 514 Ursulines. 
July 19— N. T., Italian, aged 29— Typhoid, 533 St. Philip. 

July 19— V. 'S,, Italian, aged ^Typhoid, 1139 Royal. 

July 19 — L, B., Italian, aged 68^^Typhoid, 1031 Chartres. 

July 19— R. M., Italian, aged 56— Typhoid, 1117 Decatur. 

July 20— J. L., Italian, aged 53— Malarial fever, 17th St. Ganal. 

July 20— L. E., Italian— Typhoid, 1022 Conti. 

July 20 — ^S. v., Norwegian, aged 30 — Typhoid and Ac. Nephritis. 

July 20— G. D. A., Italian, aged 51— Typhoid, 528 Ursulines. 

July 20— B., Italian, aged 19— Typ'hoid, 528 Ursulines. 

July 22— M. C, Italian, aged 38— Typhoid, 624 St. Philip. 

July 22— D, di V., Italian— Malarial fever, 1115 Gallatin. 

July 22-^G. R., Italian, aged 38 — Typhoid, 524 St. Philip. 

July 24 — M. G., Italian, aged 24 — Anuria, 530 Ursulines. 

The report of these deaths is submitted as ^'suspicions'* 
for the chief reason that they occurred in the ''Infected 
District," or bore some relation to this locality. 

Among other things which New Orleans learned for 
herself and taught the world is that free publicity should 
be given to the first case. It does not pay tO' keep it as 
a secret, because it is a secret that refuses to be kept, 
and other reasons. The watchword for all communities 
when dealing with a contagious disease is Publicity. 



STATISTICAL REVIEW, 1905 LAZARD. 1081 

The figures below are as the cases appeared, are official, 
and were compiled by the writer in his daily report to the 
officer in command during the epidemic. From the in- 
ception of the disease to August 8th, the City Board of 
Health was in charge; after this time until to close of the 
epidemic in November, the U. S. Public Health and 
Marine Hospital Service^ — Dr. J. H. White in command, 
was in charge of the fight against the disease. The disease 
was fought on lines laid down by the mosquito doctrine; 
its success is a part of the history of the city, and a bright 
example of modern epidemiology. 

When quarantine was declared against the city, it was 
agreed upon that there must have been 100 cases and 20 
deaths prior to this date. A figure which is approxi- 
mately correct as in the beginning of the epidemic and up 
to August 5, the mortality was about 20 per cent. When 
the Marine Hospital Service took charge August 8, there 
were 101 foci, counting the ^'Infected District" as a single 
focus. On November 7, there had been 842 foci — meaning 
that there were 842 squares in which yellov^^ fever had 
occurred. 

A "focus" was arbitrarily fixed and had no practical 
value in watching the course of the disease ; it came about 
by staining the map of the city in the square in which 
a case appeared for the first time. A focus when once 
established was counted throughout the epidemic as a 
focus, when as a matter of fact it was no longer infectious 
It is best in all epidemics to give the public all informa- 
tion desired, but this must be of the character that will 
be understood. A focus was not understood, and the 
public assumed very correctly from its limited knowledge 
that there were 842 points of infection in the city. 

DAII,Y RECORD OF CARKS AND DEATHS AND CASES UNDER TREATMENT, 

1905 EPIDEMIC. 
Under 
Treatment Date 

July 26 
27 
28 
29 
30 
31 



Date 


Cases 


Deaths 


July 20 


100 


20 


21 


— . 


1 


22 


20 


3 


23 


10 


2 


24 


14 


1 


25 


11 


4 







Under 


Cases 


Deaths 


Treatm't 


15 


€ 




26 


2 




21 


3 




29 


7 




27 


3 


221 


21 


5 


158 



1082 augustin's history of yellow fever. 









Under 








Under 


Date 


Cases 


Deaths 


Treatment 


Date 


Cases 


Deaths 


Treatm't 


Aug. 1 


42 


6 


177 


Sept. 16 


42 


2 


370 


2 


32 


11 


190 


17 


24 


2 


363 


3 


54 


5 


226 


18 


34 


6 


351 


4 


43 


.5 


257 


19 


34 


4 


341 


5 


30 


8 


'270 


20 


50 


6 


365 


6 


28 


8 


266 


21 


36 


4 


359 


7 


32 


8 


272 


22 


37 


4 


352 


8 


60 


4 


306 


23 


45 


6 


352 


9 


63 


7 


338 


24 


24 


2 


331 


10 


68 


5 


385 


25 


37 


3 


322 


11 


61 


9 


401 


26 


31 


5 


308 


12 


105 


9 


476 


27 


19 


6 


300 


13 


50 


12 


465 


28 


23 


4 


291 


14 


55 


12 


470 


29 


28 


2 


287 


15 


62 


6 


504 


30 


31 


2 


272 


16 


66 


4 


546 


Oct. 1 


23 


3 


260 


17 


74 


4 


592 


2 


19 


3 


243 


18 


62 


8 


590 


3 


30 


2 


232 


19 


58 


4 


588 


4 


22 


4 


228 


20 


45 


4 


566 


5 


28 


3 


219 


21 


61 


9 


566 


6 


25 


4 


214 


22 


57 


9 


518 


7 


29 


3 


226 


23 


53 


5 


528 


8 


19 





226 


24 


44 


7 


522 


9 


17 


1 


216 


25 


65 


6 


525 


10 


18 


4 


201 


26 


47 


10 


500 


11 


16 


2 


195 


27 


31 


13 


448 


12 


15 


2 


192 


28 


45 


5 


434 


13 


25 


4 


185 


29 


45 


7 


418 


14 


19 


5 


181 


30 


46 


4 


419 


15 


9 


3 


162 


31 


41 


6 


402 


16 


15 


3 


155 


Sept 1 


39 


4 


389 


17 


6 


1 


144 


2 


37 


3 


375 


18 


5 





130 


3 


29 


3 


364 


19 


8 





122 


4 


55 


5 


405 


20 


4 





112 


5 


32 


2 


348 


21 


7 





10'5 


6 


31 


4 


357 


22 


2 


Oi 


94 


7 


35 


6 


346 


23 


4 





77 


8 


44 


4 


348 


24 


4 


2 


65 


9 


41 


1 


346 


25 


9 


2 


66 


10 


27 


7 


331 


26 


3 





57 


11 


38 





334 


27 


2 


4 


58 


12 


43 


3 


340 


28 


4 





39 


13 


43 


4 


353 


29 


2 


1 


32 


14 


49 


6 


346 


30 


4 





26 


15 


43 


2 


357 


31 


3 


2 


22 



STATISTICAL REVIEW, 1905 LAZARD. 108S 

Under Under 

Date Cases Deaths Treatment Date Cases Deaths Treatm'^ 

Nov. 1 2 19 Nov. 10 

2 10 17 11 

3 1 1 14 12 

4 1 13 

5 11 14 

6 10 15 

7 11 16 1 

8 — 

9 Total 3,402 452 

The general mortality was 13.11 per cent., though this 
must be considered as being too low for the general epi- 
demic; but for the Avant of better figures Ave may accept 
this as the mortality for the yellow feyer epidemic in 
New Orleans in 1905. It is easy to understand that many 
cases were called yellow feyer unless they showed yery 
pronounced sj^mptoms of other diseases early in their 
courses, owing to the importance of screening the cases 
early. 

Up to August 31, the Italians of natiye birth furnished 
51 per cent, of the mortality. After this date the fire 
haying consumed all ayailable material in the ^'Infected 
District" slowly became more eyident in other residential 
districts. 

Deaths Classified According to x\ge. 
Deaths from yellow feyer up to Noyember 8, 1905 : 

Ages— 1-2 8 

3-5 11 

6-10 16 

11-15 38 

16-20 56 

21-25 56 

26-30 65 

31-35 36 

36-40 47 

41-45 36 

46-50 23 

51-60 27 

61-70 10 

71-75 1 

430 



1084 augustin's history oe yellow feyer 

Conceded by Board of Health . . 20 
Unclassifled 2 



452 
Deaths by Months. 

July 57 

August 220 

September Ill 

October 58 

November 8 6 

452 

Months. Male. Female. 

July 24 13 

August 157 63 

September 73 38 

October 30 26 

November 6 

Males 290 140 

Females 140 

Board of Health . . 20 

Unclassified 2 



452 
Deaths According to Nationality. 
Nationality. Deaths. 

Italy 164 

France 39 

Germany 18 

Austria 6 

Mexico 4 

Russia 4 

China 1 

Sweden 1 

Switzerland 1 

Canada 2 

Greece . . . 3 

Ireland 3 

Australia 3 



STATISTICAL REVIEW, 1905 LAZARD. 1085 

Scotland 1 

Denmark 1 

Portugal 1 

Norway 1 

Spain 1 

Holland 1 

255 
United States 197 



452 

Louisiana furnished 137 of 197 deaths; many of which 
were of Italian parentage. 

Six negroes died of yellow fever in this epidemic. 

On August 12, there were 105 cases reported. This 
jump in the number of cases was more apparent than real 
and requires some explanation. In the interim of the 
transfer of the charge of the epidemic from the City 
Board of Health to the U, S. Public Health and Marine 
Hospital Service, there were a great number of medical 
inspector's cards which were held over for some days, while 
the arrangements were being perfected and the force or- 
ganized. It being the close of the week, Saturday, the 
cards were counted in as new cases. 

On September 16 the Diamond Festival was given, the 
revenue of which went into the yellow fever campaign 
fund. On October 26, President Eoosevelt paid the city 
a visit. His visit to the city allayed the scare, the ^'could 
get aways" returned, and commerce, which was not hurt 
as badly as in 1897 and 1898, was resumed. 

Comparative Mortality, 1904, 1905, 1906. 

Comparative mortality from all diseases for New Or- 
leans : 

1904. 1905. 1906. 

W. C. W. C. W. C. 

June 17.15 28.57 19.68 29.72 19.29 35.32 

July 16.22 28.43 19.53 22.46 15.82 30.00 

August 14.57 24.43 26.01 27.91 17.34 31.36 

September 15.19 25.14 18.57 27.77 12.54 24.41 

October 15.76 19.11 17.02 31.53 15.70 28.33 

November . 17.76 30.71 16.72 27.23 17.68 30.82 



1086 

EEQUIIiEMENTS OF THE MOSQUITO DOCTKINE.* 

BY DR. S. L. THEARD. 

Secretary to City Board of Health ^ 'New Orleans ^ La. 

It was my intention at first to prepare an elaborate 
article, reviewing and analyzing some of the more im- 
portant recorded facts and incidents of our immediate 
sanitary history (and some as yet unrecorded ones), but 
I soon realized that whatever might be said must finally 
be made to rest upon certain primary basic principles, a 
brief consideration of which would be all-sufficient; for 
upon their intelligent application must eventually depend 
the success of all sanitary operations directed at the con- 
trol of yellow fever. 

I take for granted that everybody accepts to-day the 
mosquito doctrine of yellow fever transmission — that no 
one any longer seriously disputes the fact that the 
stegomyia mosquito, a most common species of the insect 
in the South and the Tropics, is the natural conveyer of 
of yellow fever; that mosquitoes can suck up infectious 
germs from the blood-stream of yellow fever patients only 
during the first four days of the disease; that stegomyia 
mosquitoes become infectious only ten or twelve days 
after becoming contaminated; that they can transmit in- 

* The two articles whicli follow are from the pen of Dr. Sidney 
L. Theard, who has heen closely associated with the 
health affairs of New Orleans since the establishment of 
a municipal hoard of health for that city in September, 
1898, serving that body In the capacity of secretary and 
sanitary officer. The articles are reproduced from the 
transactions of the Louisiana State Medical Society for 
• 1906. They are introduced because they contain somo 
important local history not generally known, and also 
because his conclusions are so different from those gener- 
ally accepted at the time. In one of the articles Dr. 
Theard has shown, with the force of mathematic precision, 
the invaluable services rendered by him in the fever fight 
of 1905.— ^G. A. 



MOSQUITO DOCTRINE THEARD. 108? 

fection continually thereafter, at intervals of feeding, 
until cleatli; that stegomyige bite preferably in the day- 
time; that a non-immune inoculated by the bite of an 
infectious mosquito will show symptoms of yellow fever 
only three or four days afterwards (exceptionally, five 
or six). 

Rigid tests, both direct and eliminative, have established 
all of this. 

I assume also that the more important characteristics 
and habits of this species of mosquito are well-known, 
for instance, that it is a domestic, not a migratory mos- 
quito, fljing but short distances and being habitually 
found within houses. 

All of which is sufficient for present purposes. The 
fact, for instance, that only the female bites and not the 
male, is a matter of no practical importance here, how- 
ever entertaining it may be to lay audiences ; for sanitary 
measures directed at mosquito destruction will in all like- 
lihood never include the weeding out of the males from 
the females. No greater importance attaches to many 
other details, purposely omitted here for that reason. 

To maritime quarantine the application of the mos- 
quito doctrine is most simple, theo?^eticalhj : It calls for 
disinfection, with an efficient culicide, of all vessels from 
infectible ports, together with their cargo, before unload- 
ing, and the detention for five days, for observation of all 
persons from such ports. This can never be put into 
practice, however, because of the exigencies of trade and 
travel. The disinfection of the cargo of fruit vessels, for 
instance, most attractive to mosquitoes (as much so 
almost as sugar), could not be effectively carried out with- 
out so injuriously affecting the fruit as to make it un- 
marketable. Again, I seriously doubt that hindrances 
thrown in the path of an American citizen because of 
the mere possibility of his being infected in consequence 
of his accidental residence in some port classed as ^^in- 
fectible," could stand the test of law. 

There is even less probability^ that measures approxi- 
mating the extreme requirements of the mosquito doctrine 
will ever be operated in guarding against the entrance of 



1088 augustin's history of yellcw fever. 

infection by way of the back-door — the railroads; for 
experience has taught us that danger from that source is 
much less, and restrictive measures will i)robablT always 
be less stringent in consequence. 

The point which I wish to make clear and emphasize, 
is, that no system of quarantine will ever i^roTe an ab- 
solute safeguard against the entrance of pestilence. It 
will merely reduce the danger to a minimum. 

Even if an apparently ideal system could be deyised, 
sober judgment would tem^Der our expectations with the 
thought that perfection, unfortunately, is of another 
world only. 

Our present system of maritime quarantine could be 
made the highest expression of what will probably ever 
be attempted in this direction, at least for many years to 
come, by reverting to the former practice of disinfecting 
the empty hold of fruit-vessels from infect ihJe as well as 
from infected ports. This seems to have given us tem- 
porary immunity in the past, for a period of years, as was 
pointed out to this Society at its 1903 meeting. 

We cannot brush by lightly the possibility of future 
infection. Just as long as yellow fever exists, and I am 
yet to learn of a single disease which has ever been wiped 
out from the face of the earth (names change, but dis- 
eases remain) ; just as long as there are stegomyise flying 
loose somewhere in this wide world of ours; just so long 
will we have to reckon with the possibility of the re- 
introduction of yellow fever infection and be prepared to 
prevent its spread when it appears. 

What, then, should our conduct be when the disease 
shows in our midst? is the question which naturally sug- 
gests itself. 

Careful consideration of the mosquito doctrine, in its 
application to the local control of the spread of yellow 
fever, forces upon us three conclusions : 

First, ^ye must prevent the access of non-infected 
mosquitoes to yelloio fever cases during tJie first four days 
of the disease. This can only be done by the judicious 
use of the mosquito-bar, and those various oils so repul- 



MOSQUiTO DOCTRINE THIARD. 1089 

sive to mosquitoes. Necessarily the results obtained will 
largely depend upon the active co-operation of the house- 
hold. 

Second. We must destroy mosquitoes possibly already 
infected. This can be accomplished, partly by screening 
of the infected room or rooms (to prevent the escape of 
contaminated mosquitoes until they can conveniently be 
destroyed), and partly by fumigation (more especially of 
living apartments). In a measure we must again depend 
upon the co-operation of the household, both active and 
passive. 

Exceptionally another room may be prepared by screen- 
ing and fumigation, for the reception and further 
treatment of the case, and all mosquitoes immediately 
destroyed, by fumigation of the remaining rooms. 

Oiling of water containers in the infected and eight 
adjacent squares will also serve to diminish the number 
of mosquitoes liable to become infected, either from the 
actual case if the screening is imperfect or not continu- 
ously practiced, or from some other unrecognized or un- 
reported case in the same neighborhood. 

Fumigation of contiguous houses might also be prac- 
ticed, where permitted. 

Third. We must prevent the access of non-immunes to 
infected localities or infected premises. This can only be 
accomplished by the judicious use of the sanitary cordon 
at the outset, and later of a modified house-quarantine for 
the prevention of promiscuous visiting and the removal 
of persons, possibly in the incubative stage of the disease, 
from infected to non-infected districts. 

These are the three basic requirements^ — the indis- 
pensable tripod — in all measures directed at the control 
of yellow fever. They are the inevitable corollary of the 
Mosquito Doctrine; they naturally flow from it. 

To ignore any of them would be a grave mistake. Such 
omission could only result from the grossest ignorance 
of the subject or the poorest judgment. Or else we would 
have to look for its explanation in the inability to enforce 
full measures of prevention, because of a half-stand wrong- 
fully taken at the outset, and persistently kept up there- 



1090 augustin's history of yellow fever. 

after for the apparent sake of consistency — the result 
of a reprehensible and futile effort to practice that abom- 
inable policy — concealment. Futile indeed, for truth in 
the end must inevitably prevail. 

The principles themselves are not new. 

As for the methods here suggested for their enforce- 
ment, they have with me the strength of faith ever since 
my acceptance of the mosquito doctrine, and are, as suc- 
cinctly stated, the same views held and the same recom- 
mendations made, to the proper health authority, as early 
as July 13th, 1905. 

No one disputes the correctness of the first two proposi- 
tions: screening of patients and infected premises, and 
destruction of mosquitoes. Regarding the third there 
seems to be a divided opinion, (as far as I have been able 
to ascertain in conversation on the subject). Some favor 
the sanitary cordon under all circumstances; others are 
in doubt as to its possible effect for good, save in the first 
two or three cases. All, however, seem to agree that a 
modified house-quarantine is most important. 

By modified house-quarantine I mean the stationing of 
guards at the door of infected premises to prevent re- 
movals and promiscuous visiting. No further restrictions 
need be placed on the members of the household, who can 
not, as we now know, convey infection to others, and who 
would be at perfect libertj?^ to enter and leave the house 
as they please. In the light of the mosquito doctrine, 
the stringent measures of 1897 are no longer permissible. 

Guards might, additionally, be stationed at the four 
corners of badly infected squares. And if the desirability 
of operating this measure be granted, we have, in essence, 
the rudiments of a sanitary cordon, which can be made 
large or small acocrding to the exigencies of the case, 
and the amount of infection to be contended with. With 
this important difference, however, that such restrictive 
measure should be applied at the very outset, on the first 
intimation of the i)resence of infection, in an endeavor to 
strangle the disease outright, and not be gradually evolved 
as the epidemic progresses. 



MOSQUITO DOCTRINE THEARD 1091 

Against lioiise-qiiarantine the only argument, with a 
semblance of force, which can be advanced, is, that rigid 
measures might tend to discourage the reporting of cases. 
To begin with, a modified house-quarantine, such as I 
have suggested, is not a rigid measure. LN^evertheless, let 
us carry the argument to its logical conclusion. There 
are persons who object to a guard in front of their house 
in small-pox; others, to sanitar}^ surveillance of conval- 
escent scarlatina cases; still others, to disinfection after 
diphtheria, or to a card on their door, or to any sanitary 
care and attention Avhich may be bestowed upon them by 
boards of health. Shall all of this be abandoned in con- 
sequence? The ver}^ absurdit^^ of the proposition be- 
comes apparent. 

The epidemic of 1905 has frequently been compared 
with that of 1878, and most laudatory conclusions have 
been drawn therefrom, from time to time. ;The truth of 
the matter is, that, while much was accomplished, a good 
deal of whpt might have been done was not even at- 
tempted. And here is the result : Though the screening of 
patients, and the wholesale destruction of mosquitoes, by 
fumigation and oiling, the number of cases was markedly 
reduced; it is probable, also, that the character of the 
epidemic was changed, from what appeared to be at the 
outset a most virulent type, to a much milder form of the 
disease; for, remember, the degree of reaction in indi- 
vidual cases depends as much upon the number of bites 
inflicted by contaminated mosquitoes as upon the degree 
of infectiousness of the contaminated mosquitoes them- 
selves. But, through failure to regulate the access of non- 
immunes to infected premises and localities, the disease 
was permitted to spread rapidly to the four corners of the 
city ; and, appearing in our midst at about the same time 
that it had shown itself in 1878, it disappeared only when 
the usual duration of yellow fever epidemics had been 
spent, some ten days sooner only than in 1878. 

These are the bare facts of the subject, presented with- 
out any blatant effort at rhetoric. 

In concluding, let me say that nothing is further from 
my mind than the desire to minimize or discredit any 



1092 augustin's history of yellow fever. 

good work which may have been done in the past^ or 
which may now be under way. The wholesale destruction 
of mosquitoes last summer was a most essential, proper 
and laudable undertaking, however costly and nowever 
much complained of at times; and the measures now 
operated throughout the city to stay the rapid breeding 
and multipil cation of stegomyise, are no less meritorious. 
At no time, in fact, should there be a relaxation in all 
those preventive measures, which alone hold out a promise 
of relative immunity. At no time should there be a lull, 
from a false sense of security, in that costly vigilance 
which is the price of safety. 



1093 
NEW ORLEANS YELLOW FEVER IN 1905.* 

BY DR. S. L. THEARD. 

If the history of the yellow fever of last summer is to 
be written in the annals of this Society, there at least 
let it be written right. 

If what I am about to say has the appearance of an 
effort at self-praise, I earnestly ask that you pause a 
while and consider, that whatever may be said by me now, 
might have been said some eight or nine months ago, that 
I i^ersistently refrained during all of that time from any 
public expressions or utterances in the matter, and that 
I am speaking now under stress of circumstances. 

The claim which I, in turn, advance (and it will be 
made good by dates and by facts), is: That the back- 
bone of yellow fever was broken in this city last summer 
whilst the lamented Dr. Richardson and myself were in 
charge of the si^ecial sanitarv operations of the Board of 
Heafth. 

As much was done then as could be accomplished at the 
time within the lines authorized by the Board of Health. 
Surely the disease could not have been aborted, for at no 
time was this feasible in the absence of any restrictive 
measures calculated to prevent the removal of persons, 
possibly in the incubative stage of the disease, from in- 
fected to non-infected districts, or the access of non- 
immunes to infected premises, and the consequent dissem- 
ination of the disease in that Avay. 

Now for the facts. 

Knowledge of the presence of yellow fever infection in 
New Orleans last summer was first had on the afternoon 
of July 12. On July 22 announcement of the fact was 
made l3y the State Board of Health. 

From July 13 to July 22 the sanitary measures prac- 
ticed were instituted, conducted and supervised by the 
City Health Officer. During that time I was engaged in 
other work at the office of the Board of Health. 



See foot note to preceding Article. 



1094 augustin's history of yellow fey.-r. 

On July 23, after the announcement of yellow fever, 
the sanitary operations of the Board were entrusted to 
my care and supervision. On July 26, Dr. Farrar Eich- 
ardson, of the Public Health and Marine Hospital Service, 
became associated with me in that work. The health 
officer at that time was engaged more especially in the 
delivery of public addresses calculated to arouse the in- 
terest of the masses in the mosquito doctrine of yellow 
fever transmission. 

On the evening of July 26, four days after being placed 
in charge of the sanitary work of the Board, I announced 
to the Advisory Committee (a committee of seven com- 
posed of two representative business men, two members 
of the Advisory Committee of the Orleans Parish Medical 
Society, and two members of the Board of Health, vrith 
the City Health Officer, also chairman of the Board of 
Health, as chairman) that I had completed the arrange- 
ment of the sanitary forces of the Board into eit'ective 
organization. 

On August 12, in response to an appeal addressed on 
August 4 to the President of the United States by in- 
fluential citizens, members of the medical profession, the 
Governor, the Mavor, the then President of the Louisiana 
State Board of Health and the City Health Officer, the 
Federal authorities assumed entire charge of the sanitary 
work in progress. Formal transfer of the emergency 
forces had been made on August 8, on pap-er, in a letter 
addressed by the Health Officer to Dr. J. H. White, of 
the Public Health and Marine Hospital Service; but the 
actual transfer occupied several days, being tinally 
effected only on the morning of August 12. 

Xow as to the deductions to be drawn from these facts. 

I have here a chart, originally i3repared some three or 
four months ago, for possible insertion in the biennial 
report of the Board of Health, then in course of prepara- 
tion. It shows the rise and fall of yellov\' fever from July 
22 to November 22. (Xo record was kept of cases reported 
from July 12 to July 22, and none can be presented). 

Dots with a connecting light line show the number of 
cases reported from day to day ; heavy unbroken lines are 
made to divide the chart into periods of fifteen days ac- 



NEW ORLEANS, 1903 THEARD. 1095 

tiyity, and the reading of the various periods is facilitated 
by the introduction of a heavy brolvcn line. The reading 
of each period is made to include the figures of the first 
day of the following period for the reason that a large 
number of the cases reported each day were discovered 
the day before ; and for the additional reason that efforts 
directed at mosquito destruction were in point of fact 
begun only on the evening of July 13, after the Frey 
funeral, the sanitary operations of the Board thereafter, 
throughout the epidemic, being always from 3 P. M. one 
day to 3 P. M. the next day. 

The broken black line shows the '^epidemic tendency'' 
of The disease from time to time. 

It is not the total number of cases reported in any 
given period, as compared with the total number of cases 
in some other period, which enables us to determine the 
^^tendency'' of an epidemic to rise or to abate; it is the 
relation of the daily figures to one another, in either 
period, which establishes that fact. For example: If in 
a given period of fifteen da^^s the cases reported show 
as 2, 4, 6, 8 and so on up to 30, and in the next period 
as 30, 28, 2Q, etc., down to 2, the total in either case 
will be the same — ^240 ; but clearly in the first period the 
disease would be increasing and in the second period it 
would be decreasing. Bare figures here mean nothing; it 
is the fact or incident back of them which counts. To 
make this still stronger : If the daily rate of report was 
2, 4, 6, etc., up to 30 in one period, and 30, 29, 28, etc., 
down to 16 in the next period, we would, in the first in- 
stance, have a total of only 240, as against 345 in the 
next period; still the disease would be clearly increasing 
in the first, and decreasing in the latter instance. 

There is a great difference between the nnmher of people 
walking in a given place and the direciion in which they 
Avalk. And the numerical strength of a retreating army 
is a matter of secondary importance when chronicling the 
fact that it is being routed. 

'It matters not that the disease was decreasing less 
rapidly than it had increased; tlie fact that it was decreas- 
ing remains. And clearly, a disease which is decreasing 
is beino' controlled and is on the wane. 



1096 




1097 






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Si » • 



'i;-c:^o 



11 



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m 



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Ota 



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iff 



1098 augustin's history of yellow fever. 

So ninch for the value of bare figures unsupported by 
facts or logical analysis. I now revert to the main 
proposition. 

From a sanitary point of view, the result or effect of 
efforts directed at mosquito destruction on a certain day, 
becomes noticeable only fifteen days afterwards. With 
this important diff'erence between ''point of time'' and 
"point of effect'' well in mind, it must be apparent, even 
to the most superficial observer, that the sanitary control 
of yellow fever was well in hand at the time that the 
Federal Authorities took charge. Clearly the top was 
knocked from the epidemic as the result of the sanitary 
measures operated from July 28 to August 11; and 7(7/ o- 
erer teas then in charge deserves credit for that ivork. 

The meat and substance of it all — shown graphically 
on the chart presented — established definitely and abso- 
lutely and beyond all cavil, is: that the epidemic was on 
the ascending scale up to August 12 as the result of the 
naif-measures practiced prior to the announcement of 
yellow fever and during the few days required after that 
to bring order out of chaos and arrange the sanitary forces 
of the Board of Health into effective organization; that 
it was on the descending scale during the fifteen days 
which followed, as the result of the work conducted by 
Dr. Eichardson and myself; that the fever showed a ten- 
dency to rise during the next fifteen days, jirobably be- 
cause of the swapping of horses in mid-stream, the United 
States Public Health and Marine Hospital Service having 
taken full charge of the work by that time: that it aoain 
abated during the followino- fifteen days; that the fever 
was never aborted at any time ; that after the main force 
of the epidemic had been taken away from it (through 
work performed from July 28 to August 11, as expressed 
from August 12 to August 20) the fever thereafter ran a 
mild course under the continuous sanitary measures ap- 
plied ; but that it finally disappeared onlv after the usual 
l^eriod of duration of yellow fever epidemics had been 
reached — from three to five months — in this instance, 
approximately, five months. 

Dr. Theard also said : 



NEW ORLEANS, 1905 THEARD. 1099 

"I wish to add that the word epidemic has not been 
used by me in the usual and more commonly accepted 
sense of the Avord^ — that a majority of the people were 
afflicted with the disease, or that the deaths from the 
disease were for a time in excess of the total deaths from 
all other diseases; but merely and only in the sense that 
it was ^'on the people," very much as rain might be, ex- 
tending as it did from Carrollton to the Barracks, and 
from the Eiver to the Lake. 

^^I also wish to say that some may possibly lean to the 
belief, held by a few, that fifteen days is too short an in- 
terval of time to judge of the effect or result of efforts 
directed at mosquito-destruction — that an interval of 
eighteen or twenty days is required. If so, it will only 
strengthen my position, for I would not be called upon, 
then, to explain the apparent lack of success following the 
work practiced during the few days which I stated had 
been required to arrange the forces of the Board into 
effective organization." 



1100 augustin's history of ykllow fever. 

ANTI-MOSQUITO OEDINANCES. 

Full Text of the Measures Adopted by the City 

Council of New Orleans During the 

Epidemic of 1905. 

On August 1, 1905, at a time when the yellow fever 
epidemic was spreading with alarming rapidity, the City 
Council of New Orleans, adopted the following ordinance : 

Ordinance No. 3196. N. C. S. 

Section 1. Be it ordained by the Council of the City 
of New Orleans, that no water liable to breed mosquitoes 
shall be stored within the limits of the city, except under 
the following conditions: 

Sec. 2. Water kept in cisterns, tanks, barrels, buckets 
or other containers for a period longer than one week 
shall be protected from mosquitoes in the following man- 
ner: Cisterns shall be covered with oil by the property 
owner or agent thereof within forty-eight hours after the 
promulgation of this ordinance and provided with a cover 
of wood or metal ; all openings in the top or within six 
feet of the top larger than one-sixteenth of an inch to be 
screened with netting of not less than eighteen mesh, 
or cheese cloth or other suitable material by the property 
owner or agent thereof within forty-eight hours after 
the promulgation of this ordinance; provided, that after 
the first day of October, 1905, all property owners shall 
be required to screen cisterns with wire netting of the 
proper size mesh as required by the Board of Health in 
such a manner as to prevent the entrance of mosquitoes. 

Sec. 3. Tanks or barrels or similar containers to be 
constructed in the manner provided for cisterns, or in 
some other manner satisfactory to the Board of Health. 

Sec. 4. Buckets containing water for longer than one 
week (such as fire buckets in cotton presses) and other 
similar containers of stagnant water, shall be covered in 
such a manner as to prevent the entrance of mosquitoes. 

Sec. 5. Water in ponds, pools or basins, in public or 



ANTI-MOSQUITO ORDINANCES, 1905. 1101 

private parks, jDlaces of resort or residences, or in depres- 
sions or excavations made for any purpose, shall be stocked 
with mosquito-destroving- fish, or covered with protective 
netting- or shall be drained olf at least once every week, or 
shall be covered with coal oil in a menner satisfactory 
to the Board of Health by the owner or agent thereof 
within forty-eight hours after the promulgation of this 
ordinance. 

Sec. 6. The Board of Health may, in its discretion, 
whenever deemed necessary, treat stagnant water by ap- 
plying oil to its surface in such a manner as to destroy 
mosquitoes. 

Sec. 7. The object and purpose of this ordinance is 
declared to be the preventon of the spread of disease by 
the destruction of mosquitoes. 

Sec. 8. The penalty for violation of this ordinance or 
any section thereof, shall be a fine /of not more than 
twenty-five dollars or imprisonment for not more than 
thirty days, or both, and failure to comply with any pro- 
vision shall be considered a separate toffense for each day 
of its continuance after proper notification by the Board 
of Health. 

On September 26th, the following ordinance was passed : 

No. 3277, NEW COUNCIL SEKIES. 

AN OEDINANCE to promiote the public health by pre- 
scribing the manner in which water liable to breed 
mosquitoes shall be cared for within the limits of the 
City of New Orleans. 
Be it ordained by the Council of the City of New 
Orleans : 

Section 1. That it shall be unlawful to set up, have, 
keep or maintain on any premises in the City of New 
Orleans, any cistern, tank or well that is not screened 
with wire mesh not coarser than eighteen (18) wires to 
the inch, both ways, provided that the inlets and outlets 
of such cisterns, tanks or wells may be screened in any 
manner or with any material approved by the Board of 
Health of the City of New Orleans, that will thoroughly 



1102 augustin's history of yellow fever. 

prevent the ingress or egress of mosquitoes to and from 
the water therein contained; provided, however, that no 
water seal shall be used in screening an^- such inlets or 
outlets. 

Sec. 2. That it shall be unlawful to have, keep or 
maintain on smj premises in the City of New Orleans, 
lot or batture, or in any cemetery, j)ark or square, any 
pond, pool, fountain, trough, urn or water receptacle of 
any similar character or kind, unless the same is kept 
constantly covered with kerosene oil from February 1 to 
December 1 in each year, or be kept constantly stocked 
with mosquito-destroying fish, or covered with the protec- 
tive netting specified in Section 1. 

Sec. 3. That it shall be unlawful between February 1 
and December 1 in each and every year to have or keep on 
any premises, water in any can, pitcher, bowl, bottle, tub, 
bucket, barrel, trough or other receptacle, unless the same 
be thoroughly emptied, dried or cleansed every five (5) 
days before being refilled; x>rovided, however, that fire 
barrels may be maintained on premises, provided that 
they are properly screened with 18x18 wire mesh, but all 
fire buckets shall be maintained empty. 

Sec. 4. That it shall be unlawful to have or maintain 
on any premises in the City of New Orleans any open well, 
unless the same be continuously closed or screened as 
above provided, so as to prevent the ingress or egress ot 
mosquitoes to and from the water therein contained and 
the drawing of water therefrom be operated by pumps. 

Sec. 5. That it shall be unlawful to have or maintain 
any gutter or drain or roof in or on which water stands 
after rains, without drawing off thoroughly. 

Sec. 6. That it shall be unlawful to have, keep or 
maintain on any premises in the City of N^w Orleans, 
any open cesspool or privy vault, to the liquid contents 
of which mosquitoes have ingTess or egress, unless the 
same be thoroughly covered with petroleum oil every fif- 
teen (15) days from February 1 to December 1 in each 
and every year. 

Sec. 7. That every lot or square in this city, which, 
in the judgment of the Board of Health, is near enough 



ANTI-MOSQUITO ORDINANCES, 1905. 1103 

to the house of its inhabitants on which water stands in 
pools or ponds, or which contains excavations or holes or 
depressions in which water may stand, is hereb}^ declared 
a menace to public health, and the owner thereof who 
shall fail, after notice by the City Board of Health and 
within the time therein prescribed, to fill or drain the 
same or keep it covered with petroleum oil, shall be 
deemed guilty of a violation of this ordinance. 

Sec. 8. That it shall be unlawful to set up, have, keep 
or maintain in any house or hotel, water closets furnished 
with a tank or basin with water seal, unless such tanks 
or basins be emptied and the water therein (renewed at 
least once in five (5) days, from February 1 to December 
1 in each and every year, or be kept during same period 
thoroughly covered with kerosene oil. 

Sec. 9. That the City Board of Health shall cause this 
ordinance to be enforced in all its provisions, and to that 
end said board or j^ersons acting under its authorit}^ shall 
have the right any time from 9 a. m. to 4 p. m. each day 
to enter upon premises, lots, squares, parks or battures, 
and any person charged with any of the duties imposed 
by this ordinance failing, after notice by said Board of 
Health and within the time prescribed by said notice, to 
perform said duties, shall be deemed gnilty of a violation 
of this ordinance, and for each day after the expiration 
of said notice the party notified fails to comply with said 
notice shall be guilty of a separate violation of this ordi- 
nance, and all fines collected for violations of this ordi- 
nance shall be paid to the City Board of Health by the 
Kecorder collecting the same ; provided, however, that no 
notice from the Board of Health or its officers shall be 
required to hold any person liable to penalties for the 
violations of Sections 1, 2, 3, 4, 6 and 8 of this ordinance, 
the provisions of which sections are declared to be self- 
operative and imperative; but in cases under those sec- 
tions where screening has been improperly done originally, 
or where the screening has gotten out of order, or has 
been injured and rendered defective without the knowl- 
edge of the owner, or, if absent his agent, then the pen- 



110 4 augustin's history of yellow fever. 

alties shall be imposed only on failure, after notice, to 
make the necessary changes and reiDairs. 

Sec. 10. The owners, and, in their absence, the agents 
of OAvners, of all premises, lots, squares, j)arks or battures 
in the City of Xew Orleans, shall be liable for riolations 
of the proYisions of Sections 1, 4, 5 and 7 of this ordi- 
nance, except in cases where, without the knowledge of 
such owner or agent, the tenant of or trespasser on any 
jDremises, lot, square, j)ark or batture shall yiolate the 
j)roTisions of this ordinance, in which eyent such tenant 
or trespasser shall be liable for such violation ; where the 
jDremises are racant, or are occux)ied jointly by the owner 
and his tenant or sub-tenant, the owner, or, in his ab- 
sence, his agent, shall be liable for violations of Sections 
2, 3, 6 and 8 of this ordinance. The tenants or occu- 
piers of all premises, lots, etc., shall be liable for viola- 
tions of Sections 2, 3, 6 and 8 of this ordinance, and. in 
the case above provided, for violations of Sections 1. 4:. 
5 and 7 thereof. 

Sec. 11. That ajiy person who shall violate any section 
of this ordinance, shall be punished by a fine of not more 
than twenty- five (|25) dollars, or by imprisonment for 
not more than thirty ( 30 ) days, or both, in the discretion 
of the court having jurisdiction. Each and every day of 
failure to comply with any of the provisions of this ordi- 
nance shall constitute a separate offense and be i3unished 
as such. 

Sec. 12. That this ordinance shall be enforced on and 
after January 1, 1906; until that date Ordinance Xo. 
3196, N. C. S., shall remain in force, except so much there- 
of as requires wire screening to be completed by October 
1, 1905, which part of said ordinance is hereby repealed. 



PART V. 



THE ACCEPTED 



MODERN THEORIES 



CONCERNING 



YELLOW FEVER 



1107 



THE ETIOLOGY OF YELLOW FEVEK. 

From the Standpoint of 1908 and iiv Retrospect. 
By G. Farrar Patton^ M. D., New Orleans. 

Professor of Clinical Medicine, Post-Graduate Department, Tulane 

University of Louisiana; Secretary Louisiana State Board 

of Health, 1896-1906. 

I. 



First Definite Suggestio7i of the^Truth. 

Nowhere in the history of scientific research is there a 
more conspicuous instance of the tenacity with which 
nature seems to guard her secrets than in the long and 
deadly struggle it has cost mankind to wrest from her the 
secret, so priceless and yet so simple w^hen discoYered, 
of the causation of yellow fever. When we think of the 
countless learned men who, singly and as members of 
special commissions, haye so earnestly and patiently 
labored, generation after generation, to solve this vital 
problem, while the insect by which the infection is con- 
veyed mockingly buzzed about their heads, we cannot 
pay too high a tribute to the acumen of Dr. Carlos J. 
Finlay of Havana, who as far back as 1881 not only ad- 
vocated with absolute confidence the doctrine that yellow 
fever is conveyed by the bite of a mosquito, but correctly 
designated, as was proved twenty years later by the ex- 
periments of the U. S. Army Comimdssion under Burgeon 



1108 augustin's history of yellow fever. 

Walter Eeed, the particular mosquito, and the only one, 
so far as known, by which the disease is transmitted to 
man. 

Unfortunately, Finlay did not at that time have the 
advantage enjoyed by later investigators of deriving help- 
ful suggestions from the knowledge of the role played by 
the mosquito in malarial fever, but reasoning on the sim- 
ple doctrine of direct inoculation, he thought that the pro- 
boscis of the mosquito biting a patient ill with yellow 
fever became contaminated with the virus of the disease, 
which in turn wa,s directly infused into the blood of 
other persons subsequently bitten by the same mosquito, 
thereby conveying the disease to those who were not im- 
mune. For reasons now well understood the experiments 
made by Finlay to prove his theory were uniformly un- 
successful, but he remained unshaken in his belief that 
the particular house mosquito known to us as the Ste- 
gomyia Calopus} which he observed to be invariably 
present in connection with yellow fever, was the active 
agent for its transmission and, unlike many pioneers who 
have advocated a truth before the world was; ready to 
receive it, he has lived to see his sublime faith triumph- 
antly vindicated. In one of his able monographs Surgeon 
H. K. Carter, of the U. S. P. H. & M. H. Service, aptly 
refers to Finlay's thus singling out the Stegomyia mos- 
quito in its causative relation to yellow fever as "a very 
beautiful piece of inductive reasoning." 

If Finlay could have ascertained what Carter later de- 
termined, viz. : that a definite period of time must always 
intervene between infecting and secondary cases, an ob- 
servation impossible to make in Havana, where the dis- 
ease was continuous, he would probably not have failed, 
because he would almost certainly have taken the hint 
and have kept some of his infected mosquitoes over that 
period. 

It came as a fitting sequel to Finlay's long and undis- 
couraged advocacy of the transmission of yellow fever 

^Formerly called Culex fasciata, and now named Stegomyia 
calopus. 



ETIOLOGY PATTON. 1109 

by mosquitoes that the immortal work of the U. S. Army 
Commission, consisting of Drs. Walter Reed, James Car- 
roll, Aristides Agramonte and Jesse W. Lazear, by whom 
in 1900 and 1901 the correctness of this discredited theory 
was demonstrated to the world, was undertaken and 
completed at Havana, Finlay's home city, where for 
twenty years he had been regarded as hopelessly vision- 
ary on the subject. Surelj', the prophet shall not be with- 
out honor, and it takes away nothing from the imperish- 
able fame of Walter Eeed and his collaborators, one of 
Avhom, Lazear, died a martja^ to the cause, while Carroll 
barely escaped the same fate, for us to give Finlay due 
credit for abstractly reasoning out a great truth and for 
so steadfastly upholding his belief despite of his inability 
to prove it. The substantial vindication of that truth 
constitutes, in the opinion of the writer, an achievement 
outranking in value to humanity and to science any 
single triumph the world has ever known, and has happily 
settled forever the practical aspect of the etiology of yel- 
low fever. 

Wlien we say that the practical aspect of this long 
vexed question is at last settled we speak advisedly, since 
the "germ" of the disease remains as „yet (in 1908) undis- 
covered and because, after our many tribulations, we have 
so much reason to be content with our present knowledge 
that for practical purposes we can afford to rest where 
we now stand. 

TJie Yelloic Fever Germ. 

Of course, there is a special pathogenic entity concerned 
in the causation of yellow fever, since nothing can come 
•into existence without^ a definite cause, but it would ap- 
pear that here we have to do with a soluble toxin that is 
ultra-microscopic and so intangible as to be susceptible of 
filtration through the very finest grained porcelain with- 
out losing any of its virulence, as shown by the fact that 
the serum of blood taken from a yellow fever patient with- 
in the first three days and passed through a Chamberland 



] no 



AUGUSTI?v S HISTORY OF YELLOW FEVER. 



filter has comtoLunicated the disease hj being injected sub- 
cutaneouslr into the srsteni of a non-immime person. 

So eranescent is this poison, that after the third day of 
illness it seems to disappear from the blood of the human 
subject. 

Writers of the present day refer to the germ of yellow 
fever as a ^'parasite/'' following the idea of analogy,' mtich 
as chemists have classified the hypothetical metal ammo- 
nium. In a recent monogi-aph on yellow ferer. Dr. Joseph 
Goldberger,- of the U. S. P. H. & M. H. Service, writes 
as follows on the subject: 

''TJic Parasite. — While the organism of yellow fever 
lias not yet been discovered, we are, nevertheless in pos- 
session of Some facts which enable us to form some idea 
of its character. The disease has been found to occur 
only in man and the mosquito, so that it is inferred that 
the parasite is one of those that requires for the comxilete 
evolution of its life cycle a mammalian and an arthropod 
host. We have familiar analogies in Piroplasma hige- 
miniim of Texas fever and the Plasmodium of malaria. 
Because of these analogies it is inferred that biologically 
it may be grouped with them as a protozoon. On the 
basis of these and other analogies, both Schaudinn 1 1904 i 
and ^ovy & Knapp (1906) have suggested that it may 
be a SpirocJiaeta. Stimsoh's recent discovery of a spiro- 
chiete-like organism in the tubules of a yellow fever kid- 
ney is therefore exceedingly interesting and suggestive." 

It is now historical how enthusiastically the scientific 
world welcomed the announcement by Sanarelli in 1S9T, 
that he had succeeded in isolating the long sought germ 
of yellow fever, and how great the corresponding disap- 
pointment was when his famous Bacillus Icteroides later 
proved to be something merely associated with the disease 
without standing in any causative relation to it. Since 
that disappointment occurred, certain other tentative an- 

= Yellow Fever. Etiology, Sj^mptoms and Diagnosis, by Joseph 
Groldberger, July, 1907. Yellow Fever Institute Bulletin 
No. 16, Government Printing Office, Washington. 



ETIOLOGY PATTON. 1111 

nouncements of finding the elusive "germ" have been made 
only to be discredited, with the result that the medical 
profession, naturally disposed to be skeptical, is likely 
to accord a very reluctant recognition to the real parasite, 
should it be found. 

While admitting that science owes it to itself to find 
the '^germ" of yellow fever if possible, it may be said 
that from a purely practical standpoint ofl etiology it 
makes comparatively little difference to the world whether 
this discovery is ever made, since the etiology of the dis- 
ease, so far as the majority are concerneid, seems to be 
entirely comprehended in our knowledge, severely tried 
and found reliable, that yellow fever, as we know it, is 
only conveyed to man by the bite of the female Stegomyia 
mosquito under certain narrowly restricted conditions to' 
be presently named. 

This is the whole etiology of the disease in a nutshell. 

11. 

Vieics Formerly Held. 

In the light of present knowledge it is not without in- 
terest to notice briefly the views relative to the etiology 
of yellow fever formerly held by those in positions of 
authority as writers and health officials. Prior to the 
introduction of the germ theory there seems to have pre- 
vailed a general belief in a sort of poisonous miasm, either 
diffused by the body or breath of the patient, or in some 
other way generated in connection with the case. This 
miasm was supposed to be highly infectious, clinging 
tenaciously to textile fabrics and even to the furniture 
and walls of the sick-room. Woolen articles were sup- 
posed to be specially liable to attract and retain the poi- 
son. Everything thus presumedly infected was regarded 
as fomites capable of carrying the disease to another 
locality where conditions might be favorable for its devel- 
opment. 

This belief in the spread of yellow fever by fomites was 
practically universal, inspiring such abject terror during 



1112 augustin's history of yellow fever. 

certain epidemics that many cities and towns quarantined 
''against the world/"' preferring to maintain absolute non- 
intercourse and to dispense with common necessities of 
life rather than risk the accidental introduction of any- 
thing tainted with infection. 

In striking contract with the teachings of the genera- 
tion of medical authorities immediately prior to the reve- 
lation of the truth about the causation of yellow fever, 
it is to be noted with all the admiration due to a master 
mind, that La Eoche, whose classic work on the subject 
appeared in the dark days of 1855, unhesitatingly ex- 
pressed disbelief in the conveyance of yellow fever by 
f omites, devoting a large section of one volume to evidence 
and arguments against that wide-sj)read delusion. 

While there could be no doubt about the general infect- 
iousness of yellow fever, many logical observers doubted 
its being personally contagious, since so many of those 
in close contact with cases as nurses and attendants es- 
caped, while hundreds who kept carefully aloof were at- 
tacked. It seemed truly paradoxical that the ''miasm," 
which must in some way be associated with the sick, 
should be thus seemingly inoperative at the bedside, but 
potent a little distance away. 

On this particular point another thinker. Prof. Austin 
Flint, Sr., of Xew York, after residing for a time in Xew 
Orleans and carefully studying the question with the im- 
partiality of an outsider, judicially summed up^ the evi- 
dence as being strongly opposed to the doctrine of per- 
sonal contagion, declaring that — ''That great majority of 
those who have had an extensive practical acquaintance 
with the disease believe it to be non-contagious.'' 

Eelative to the etiology of the fever, he makes this 
guarded statement — "Of the nature and source of the 
special cause of yellow fever we have no positive knowl- 
edge beyond the fact that it originates without the body." 
His reference to the conveyance of the infection by fomites 
is so conservative as to suggest to one reading between 

^ Principles and Practice of Medicine. Fourth Edition, 1873. 



EFIOLOGY PATTON. 1 1 1 S 

the lines the idea that he was not very firml}^ convinced 
on this point, as when he says, ''may not the s^iecial canse 
be carried from one place to others in clothing, merchan- 
dise, etc., and the disease in this way be imported? Facts 
appear to establish the affirmative to this qnestion." 

Qnoting Dr. Josiah Nott, of Mobile, Flint further states 
that — "The special canse is most active near the ground; 
persons on a ground floor are more likely to be attacked 
than those in the stories above. The cause is more active 
at night than in the daytime." 

The Dr. Nott in question, a distinguished physician of 
his day and a thoughtful observer of facts, after ingeni- 
ous reasoning by exclusion, put himself on record in 1848, 
as considering it "probable that yellovr fever is caused 
by an insect or animalcule bred on the ground," even 
naming the mosquito as a possible factor, though not 
venturing any definite assertion on this point, as did Fin- 
lay of Havana. 

Another prominent physician of Alabama, Dr. Jerome 
Cochram, who for years prior to his death, was State 
Health Officer, commenting on the 1ct>^ lying stratum of 
infection in yelloAV fever, is quoted as saying that a v\^all 
twenty feet high T^ould check its progress. Some ob- 
server with a mathematical turn of mind actually calcu- 
lated the rate at which the fever appeared to spread from 
a known focus in a city as being about forty feet a day. 

It was a common observation that the fever would hesi- 
tate about crossing a street, but readily traversed two 
back yards to reach a house in the rear. 

The strange and unaccountable "smouldering" of the 
infection between the first and second group of cases 
had been duly noted from the earliest times, while its 
rapid spread in hot weather and magical subsidence after 
the coming of frost caused many to think that some mete- 
orological condition was concerned in its causation. 

These and other accurate observation relative to the 
behavior of yellow fever infection, so easily explained since 
the habits of the Stegomyia mosquito have been carefully 
studied, show how near to the truth those good people 



1114 augustin's history of yellow fever. 

« 

blundered without guessing it, with the mosquito all the 
while biting them and singing in their ears. 

When the germ theory of the causation of disease began 
to gain ground an entirely new and alluring turn was 
given to speculation regarding the special cause of yellow 
fever. It was at once decided that there must be a tangi- 
ble microbe, very small perhaps and difficult to isolate, 
but certainly within reach of the vaunted disinfecting 
agents of which such great results were expected. 

Thus we find Dr. Saml. Choppin, a high authority in 
New Orleans and President of the State Board of Health, 
declaring in his report for 1878 (page 10) that the mari- 
t'me quarantine policy of his Board was ''based on the 
hypothesis that the materies morhi of yellow fever con- 
sists of living germs, probably animalcular. The object 
is to attack those germs, wherever existing, by agents de- 
structive to l^w forms of life without being injurious to 
their habitat." 

The germs were supposed to cling to all sorts of fomites 
coming from tropical ports and especially to proliferate 
in the' bilge water of wooden ships, it being held by many 
authorities that decaying wood was the most favorable 
nidus for their growth and diffusion, which theory easily 
explained the transportation of the disease by ships and 
the frequency with which laborers working in the holds 
of such ships at previously healthy ports were the first 
persons attacked by fever. 

It may be mentioned in passing that the nev/ era of 
maritime quarantine practice so successfully inaugurated 
in 1885 by the Louisiana State Board of Health under 
Dr. Joseph Holt comprised the forcing of sulphur dioxide 
by a powerful suction blower intO' every portion of the 
ship's hold, thereby killing any infected mosquitoes which 
might have been lurkino- there when the vessel sailed from 
a tropical port, while simiiiar fumigation in detail was 
performed by burning sulphur in every living space of the 
vessel, making a clean sweep of all mosquitoes on board. 
Under the prevailing delusion about ''germs" disinfection 
of all fomites by steam heat was also laboriously per- 



ETIOLOGY PATTON. 1115 

formed, this part of the work getting the principal credit 
for the good accomplished, after Avhich detention sufficient 
to cover the estimated incubation period of the disease 
was enforced. ^ 

With the further development of the germ theory and 
with the trend of thought induced by the researches of 
Koch, Eberth and others, we note a disposition to look 
for the germ of yellow fever as affecting specially the 
alimentarj' canal. Thus, in the section on j^ellow fever 
in Loomis & Thompson's American System of Med^'cine, 
published in 1897, we read the following by no less an 
authority than Sternberg: 

^'Yellow fever is not a contagious disease in the strict 
sense of the word, i. e., it is not usually contracted by 
contact with the sick ; but, as in cholera and typhoid fever, 
the infectious element multiplies in the body of the sick, 
and epidemics usually extend from foci of infection origi- 
nating from the introduction of cases of the disease into 
localities previously free from it. \ 

Although not definitely demonstrated, it seems ex- 
tremely probable that this occurs in the same way as in 
the diseases mentioned, viz., through the excreta. This 
is indicated by the fact that while contact with the sick 
as nurse or physician does not lead to infection, the soiled 
clothing and bedding of yellow fever patients may induce 
an attack in those who handle them, and may originate 
an epidemic when transported without having been dis- 
infected to another locality.'' ***** 

"As heretofore suggested, the yellow fever patient, like 
the patient with cholera or typhoid fever, probably carries 
"germs" in his intestines which are capable of abundant 
development outside the body Avhen local conditions are 
favorabJe. * * * * * 

"In A'iew of the facts heretofore recorded and the con- 
clusions reached as the result of experimental investiga- 
tion, it is evident that the dejecta of yellow fever patients 
should be regarded as infectious material and should 
never be thrown into privy vaults until they have been 
completely disinfected." 



1116 AUGUSTIX'S HISTORY OT YELLOW FEVER. 

III. 

Tyranny of a False Doctrine. 

Whatever diyersity of views existed as to other points 
in connection with yellow fever, physicians and laymen 
of the South were practically united in cherishing a 
deeply rooted belief in its transmission by fcmites. That 
this conviction prevailed must appear not only natural, 
but inevitable, in view of the great mass of testimony in 
support of that belief which has been handed down from 
tlie past by jDerfectly honest witnesses. In fact, some of 
the reported instances^ of the apparent transmission of 
yellow fever by fomites cannot possibly be reconciled with 
our present knowledge, comioelling the conclusion that 
something is wanting in the evidence. It was not strange, 
therefore, that medical men of the South, and especially 
those officially charged with the responsibility of framing 
regulations for the protection of the public health, were 
somevrhat slow in accepting the mosquito doctrine in its 
entirety. 

Dr. Edmund Souchcn, President of the Louisiana State 
Board of Health, from February, 1898, to January, 1906, 
and whose administration was thoroughly progressive, in 
his Eeport for 1900-01 (pp. 78-9), correctly defined his 
own position and that of other Southern Health Officials, 
as follows : 

"While admitting that the mosquito has been shown 
to be a potent factor in conveying the disease, we South- 
ern Health Officers, charged with the grave duty of pro- 
tecting our people against this most dreaded of all dis- 
eases, are unwilling to accept the dicttim of the experi- 
menters that yellow fever can be conveyed by no other 
agency. 

* Those interested will find a compilation of twenty-seven 
authentically reported instances in Dr. Edmond Souchon's 
paper on the "Treatment of Vessels from Yellow Fever 
Ports"; X. y. Medical Record, Feb. 8th, 1902. (Reprinted 
in the Biennial Report of the Louisiana State Board of 
Health for 1900-01, pp. 81-102.) 



ETIOLOGY PATTON. J 1 l7 

We are willing to be convinced, but are not prepared 
to abandon established quarantine precautions on the 
strength of such negative evidence as that afforded by the 
reported experiments with fomites." 

Dr. Souchon, without for a moment questioning that 
yellow fever is convej^ed by the bite of a mosquito, was 
not willing to admit that fomites or other causes could 
not also transmit the disease until time and further proofs 
should demonstrate this beyond all possibility of doubt. 
He felt that until this was done he would not be justified 
in altering the quarantine regulations, especially as the 
people of Louisiana, whose officer he was, still believed 
firmly in the conveyance of ^^ellow fever by fomites. 

In justice to Dr. Souchon and other leading sanita- 
rians of the South, it is to be noted here that they lost no 
time in profiting by the evidence in support of the mos- 
quito doctrine which continued to accumulate at localities 
where the occurrence of yellow fever afforded opportuni- 
ties to verify in actual practice the conclusions relative to 
fomites previously based only upon experiments, so that 
long before the outbreak in Texas in 1903 the useless- 
ness of disinfection in yellow fever for any other object 
than the destruction of mosquitoes had been officially rec- 
ognized in Louisiana and to a great extent in adjoining 
States. 



IV. 

Coinvincing Object Lessons of 1905. 

It is safe to assert that the experience gained during 
the prevalence of yellow fever in Louisiana and Missis- 
sippi in 1905 had the effect of banishing the last lingering 
belief in the conveyance of the disease by fomites so far 
as the vast majority of medical uiien in the South were 



1118 AUGUSTIn's HISTORY OF YELLOW FEVER. 

concerned^ During that outbreak no attention whatever 
was paid to the disinfection of the clothing and bedding 
of patients by the State and Federal authorities who con- 
ducted the campaign, the first on record in which the 
fever was conquered before the coming of frost, all work 
being planned and carried out in strict accordance with 
the doctrine of its natural transmission occurring solely 
by the bite of the Stegomyia mosqnito. 

The magnitude of the demonstration given to the world 
hj that campaign left no ground for any objection that 
might have applied to experiments on a small scale or 
under artificial conditions. After that vast and costly 
object lesson in otir own territory, the only "doctors'" left 
unconvinced were (and are) a few old timers who still 
cling to the traditions of the x>ast, refusing to be per- 
suaded that an insect as feeble and apparently insigni- 
ficant as the mosquito can be the sole agent concerned in 
conveying a disease so terrible as yellow fever. 

V. 
Etiological Role of the Mosquito. 

So thorough and complete was the work done by the 
T7. S. Army Commission in Havana, as set forth in their 
successive reports,^ that aside from abundant confirma- 

'In New Orleans the great mass of the laity hecaine ready 
converts to the mosquito doctrine. This result was accom- 
plished largely through good missionary work done in the 
city and by public meetings and lectures; but the people 
themselves entered, heart and soul, into the great fight of 
1905, and after witnessing the wonderful success of this 
new method of warfare against their ancient enemy 
needed no further proof that the doctrine underlying that 
method must be correct. 
® The Etiology of yellow fever. A preliminary note. — Re3d, 
Carroll, Agramonte and Lazear. Phil. Med. Journal, Oct. 
27, 1900. 

The Etiology of yellow fever. An additional note. — Reed, 
Carroll and Agramonte. Jour. Amer. Med. Assn., Feb, 
16th, 1901. 

The Prevention of Yellow Fever. — Reed and Carroll. X. Y. 
Med. Record, Oct, 26th, 1901. 

The Etiology of yellow fever. A supplemental note, — Reed 
and Carroll. American Medicine (Phila.), Fe>b. 22d. 1902. 



ETIOLOGY PATTON. 1119 

tiou by other trustworthy experimenters and the convinc- 
ing" proof of the correctness of their deductions afforded 
by the success with which the same have been applied in 
tlie practical management of yellow fever, it may be said 
that nothing essential has been added to our knowledge 
of the mosquito doctrine since it was formulated by its 
discoverers. The bas^c principles of that doctrine in 
relation to the etiology of yellow fever (without direct 
reference to quarantine and sanitary work ) may be briefly 
stated, as follows: 

L The only natural agency by which yellow fever is 
transmitted to human beings is the bite of an infected 
female ^tegomyia calojms mosquito. (Until recently 
known as Stegomyia fasciata). 

2. Therefore, the disinfection of inanimate objects, as 
formerly practiced for protection against the disease, is 
useless. 

3. In order to possess the power of transmitting the 
disease, the mosquito must, at least twelve days previously, 
have fed upon the blood of a yellow fever patient during 
the first three days of that patient's illness. 

4. After thus becoming able to transmit the disease, 
the mosquito retains (most probably) that power during 
the remainder of its life. 

5. Neither in the mosquito nor in the human subject 
does the Bacillus icteroides or any other parasite thus far 
discovered stand in any etiological relation to the disease. 

6. After being bitten by a mosquito capable of trans- 
mitting the infection, a non-immune person will ordinarily 
develop yellow fever within five days, the time of incuba- 
tion varying from two days and one hour in the shortest 
recorded period, to six days and two hours in the longest. 

It is proper to mention here that the French Commis- 
sino consisting of M. Marchoux, Salimbeni and Simond, 
by whom the deductions of the U. S. Army Commission 
were corroborated in a series of experiments undertaken 
to still further study the etiological aspect of everything 
connected with yellow^ fever, reported one instance in 
which the power of conveying infection appeared to have 



1120 augustin's history of yellow fever. 

been transmitted through the ova of an infected female 
insect to her progeny. Two of the most expert and re- 
liable exj)erimenters of the U. S. P. H. & M. H. Service, 
Eosenau and Goldberger, entirely failed to find any con- 
firmation of this hereditary transmission, and in the light 
of much j)ractical experience the majority of American 
authorities believe that it cannot take place. 

The scope of this article does not warrant an exhaustive 
review of various related matters of general interest, as 
for example, the habits and peculiarities of the Stegomyia 
mosquito, its distinctive appearance, mode of attack — the 
female alone biting — the influence of temperature on its 
^'pernicious activity," its longevity after becoming infected 
and ability to hibernate through a mild winter with little 
or no diminution of pathogenic vigor, as must have oc- 
curred in New Orleans following the little epidemic of 
1897, — etc., etc. 

However, tAvo of the special attributes of the Stegomyia 
caJopns are entitled to consideration here as belonging to 
the chapter of etiology. These are: 

A. The power which that mosquito alone appears to 
possess of transmitting yellow fever; and — 

B. Tlie interval of time, usually about twelve days 
(believed to be influenced by temperature) required by 
the female insect to develop that power within her system 
after feeding upon the blood of a yellow fever patient dur- 
ing the flrst three days of that patient's illness. This in- 
terval is the ^'Extrinsic Incubation" of Carter,'^ who, in 
1898, made a careful clinical study of the subject and, 
without detecting the agency of the mosquito, correctly 
determined the period of incubation outside the human 
body as being ''usually in excess of ten days." 

A. 

The first of the foregoing points miay be regarded as 
established beyond any reasonable doubt by the negative 

^A Note on the Interval Between Infecting and Secondary 
Cases of Yellow Fever.— H. R. Carter, M. D., Surg. U. S. 
Marine Hosp. Service, New Orleans Med. & Surg. Journal, 
May, 1900. 



ETIOLOGY PATTON. 1121 

results which have attended all experimental attempts to 
convey yellow fever through the bites of other mosquitoes, 
as well as by the fact that however abundant mosquitoes 
may be at a locality in which a case of imported yellow 
fever develops, there is no sjDread of the disease unless 
the Stegomyia is present. This explains why certain in- 
terior localities have seemed to enjoy immunity, although 
in the ''yellow fever belt." ■ 

As to why this particular mosquito is the only one 
capable of transmitting yellow fever, we are thus for only 
in a position to conjecture, but venturing a seemingly 
plausible suj)position covering the whole ground, we come 
to the second point : 

B. 

From analogies of suscej)tibility and natural immunity 
observed among animals we may appear justified in 
ascribing to the delicate house-bred female Stegomyia 
hatched from the ovum of a mother fed on human blood, 
an actual susceptibility to this human disease not pos- 
sessed by any other mosquito, but with such natural power 
of resistence as to present an incubation period more 
than twice as long as in the human subject, and to remain 
physically uninjured b^^ the attack. 

iThe supposition that the mosquito experiences some- 
thing corresponding with an attack of yellow fever in the 
more highly organized human subject is consonant with 
the scientific dogma that the period of ^'extrinsic incu- 
bation" represents the cycle of development required by a 
hypothetical parasite within the system of the insect, in 
accordance with analogous examples in nature, and helps 
to account for the profound impression evidently made on 
that system. So deep and lasting is this impression, like 
that of unchecked syphilis in man, as to produce perm.^- 
nent change of function, the secretion of the salivary 
inlands of the infected niot^quito remaining tainted for 
life. 



1122 AUGUSTIX'S HISTORY OF YELLOW FEVER. 

The period of incubation in the mosquito, averaging 
about twelve days, added to the three, four or five days of 
incubation required for the development of the disease 
in the human subject, made up the interval of ''smould- 
ering" between the first case (or group) and the next 
group of cases so puzzling and deceptive in former times,, 
besides being so disastrous in results. 

Surgeon H. E. Carter of the U. S. Marine Hosptal 
Service, who is identified with much of the best yellow 
fever work done in recent years, realizing the importance 
of determining, if i)ossible, the exact relationship of this 
strange phenomenon, took advantage of a series of con- 
secutive cases at a lonely railroad telegraph station near 
Xew Orleans, in 1897, to make his first accurate observa- 
tions. These he was able to verify the next year under 
singularly favorable conditions at Orwood and Taylor, in 
north Mississippi, where the appearance of yellow fever 
among the non-immune population of a sparsely settled 
district furnished an opportunity to determine with ab- 
solute accuracy the interval between certain isolated first 
cases and the resulting secondary cases, the period of in- 
cubation in the human system having already been satis- 
factorily ascertained. In this way he arrived at the con- 
clusions on which he based his first published statement 
regarding the ''period of extrinsic incubation,-' the apt- 
ness of which designation has been generally recognized. 

The significance and scientific value of Dr. Carter's 
obsevations were not fully appreciated until the U. S. 
Army Commission working at Havana took up Finlay's 
uncompleted studies relating to the mosquito, after hav- 
ing determining that the BaciUus icferoides of Sanarelli 
is not an etiologic factor in yellow fever. This stumbling 
block having been eliminated, the genius of the united 
Commission, once started on the true path, with sugges- 
tions drawn from the analogy of malarial transmission 
by mosquitoes and the aid supplied by Carter's practical 
studies, readily worked out the remaining elements of the^ 
problem. • 



ETIOLOGY PATTON. 1123 

Tlie Commission had no difficuley in securing human 
subjects for experimentation. At the beginning, a sub- 
stantial cash bonus was offered, but with characteristic 
heroism, American soldiers offered themselves as sub- 
jects without compensation. There was plenty of yellow 
fever in Havana aud Finlay aided in obtaining the proper 
mosquitoes for the experiments. A sufficient number of 
iiisects were allowed to bite patients on successive days to 
enable the Commission to study fully all questions of 
time, with the result that it was found impossible for a 
mosquito to become infected by biting a patient after 
about the third day of illness, and also impossible for a 
mosquito, even when properly infected (i. e., by biting 
during the first three days of the attack) to transmit the 
disease to a human subject earlier than about twelve or 
fourteen days thereafter, thus beautifully demonstrating 
the rationale of Carter's "extrinsic incubation," of which 
the Commission had been duly mindful. i 

A majority of the yellow fever cases experimentally pro- 
duced, while relatively mild, were distinctly typical, but, 
as already mentioned. Dr. Lazear of the Commission died 
of an attack of the disease. Carroll, who allowed himself 
to be bitten by a stray mosquito, also had an attack so 
severe as to be nearly fatal. 

Among the supposedly non-immune subjects experi- 
mented upon some did not develop the disease, showing 
that they enjoyed a certain measure of natural immunity. 

Later, when sufficient proof of the conveyance of infec- 
tion by the bites of mosquitoes had accumulated to satisfy 
the most skeptical, experiments on human beings were 
discontinued as being attended with risk of life even when 
most carefully conducted. ., \ 

To test the reputed conveyance of infection by fomites, 
a quantity of clothing and bedding direct from yellow 
fever cases and variously soiled with black vomit, feces, 
etc., was placed in boxes and stored in an isolated house 
erected for the experiment. This house was carefully 
screened to' exclude mosquitoes, and was kept artificially 
heated to imitate natural conditions. Seven non-immune 



1124 AUGUSTIn's history of yellow FE\EII. 

subjects submitting to the experiment occuj)ied a tent 
near by during the day, being carefully protected from 
the bites of mosquitoes. Every night a squad would move 
into the screened house, where they removed the fo mites 
from the boxes, handling each article, putting on the 
soiled clothing, sleeping on beds made up with the ^^in- 
fected'' sheets and blankets, and repacking the whole out- 
jit in the boxes the next morning. Although exposed in 
this way for three weeks, not one of the seven subjects 
contracted the fever, but some of them subsequently ex- 
perienced experimental attacks after being bitten by in- 
fected mosquitoes under the proper conditions, showing 
that they were actually non-immune. 

The conclusions of the Commission were promi^tly put 
to a practical test by Major W. C. Gorgas, Surg., U. S. 
Army in charge of the sanitation of Havana, and with 
such wonderful success, following absolute failure by 
methods based on former theories, that he succeeded by 
entirely eradicating yellow fever from that city where 
the disease had been perennial from time immemorial, 
thereby carrying conviction to the minds of admiring 
scientists all over the world. 

VI. 

The Bacillus Icferoides. 

Before dismissing the subject of experimental research 
to discover the cause of yellow fever, it is not inappropri- 
ate to add a final word about the Bacillus icferoides of 
Sanarelli. This parasite, while not the actual ^^germ-' 
of the disease, is undeniably very interesting in certain 
respects. It is found in little gxotips in the capillaries 
of the liver and kidneys of yellow fever subjects, organs 
strikingly affected by the disease, and its behavior in the 
laboratory, especially as regards agglutination tests^ and 



■ ArcMnard of New Orleans found in 1S97 that among twenty 
cultures of known parasites the only one showing agglu- 
tination with yellow fever blood was the Bacillus 
Icteroides. 



ETIOLOGY PATTON. ]125 

the causation in certain animals of pathologic conditions 
typical of the disease in man, certainly justified sanguine 
belief in its being the long sought germ. Among ani- 
mals experimented upon the dog proved especially sus- 
ceptible, promptly developing characteristic symptoms of 
yellow fever, viz. : violent gastric disturbance, intestinal 
hemorrhages, albuminuria, suppression of urine and death 
in convulsions, with post-mortem findings of degenerative 
changes in the liver and kidneys corresponding with those 
present in human beings who die of yellow fever. 

Sanarelli reported ^ve cases produced in human sub- 
jects by inoculation with filtered toxin from cultures of 
the Bacillus icteroides^ all presenting clinical pictures of 
yellow fever. 

Altogether, it seemed conclusive that this must he the 
specific parasite of the disease, but the impartial investi- 
gations of the U. S. Army Commission at Havana, be- 
sides determining the absence of the Bacillus icteroides in 
the blood of a number of undoubted cases of yellow fever, 
further showed that blood serum from a fatal case, though 
absolutely sterile to culture media favorable to the growth 
of that parasite, produced an attack of yellow fever in a 
non-immune subject when subcutaneously injected. A 
similar sample of serum from the case thus experimen- 
tally produced likewise proved sterile, but also caused an 
attack resembling yellow fever when injected into the cir- 
culation of a non-immune person. 

From these observations, showing that the Bacillus 
icteroides is absent from the blood of yellow fever patients 
at times when the serum of that blood, even after being 
filtered through close grained porcelain, is fully capable 
of causing yellow fever if introduced into the system of 
non-imniunes, it is self evident that we must look else- 
where for the specific cause of the disease, however in- 
teresting from a laboratory standpoint that remarkable 
parasite may be. Here, it is evident that we still have 
something to learn. 



1126 augustin's history of yellow fever. 

VII. 
Dengue and Yellow Fever. 

In conclusion, there seems to be another and really im- 
portant field for study as regards the frequent ana hith- 
erto confusing association of yellow fever and dengue. 
Both diseases being transmitted by the bites of mosquitoes 
and often occurring simultaneously, as it were, in locali- 
ties where yellow fever almost immediately afterwards 
becomes epidemic, there would appear to be some grounds 
for suspecting a modified evolution of toxin in the system 
of the transmitting mosquito, either the Stegomyia calo- 
pus itself or of some other member of the same group, 
whereby the original poison thus modified instead of 
causing undoubted cases of yellow fever produces the sort 
of atrpical fever which in the past has proved so con- 
fusing and disastrous. 

It is, of course, very easy to explain matters by simply 
assuming that the two diseases happen to be present at 
the same time, but to those who have personally observed 
these puzzling twofold outbreaks some other explanation 
seems necessary, and it is not expecting too much of 
science, which has laid the world under so many obli- 
gations, to express the hope that in the near future the 
solution of this long standing problem will be forth- 
coming. 



1127 

THE sa:nitary pi^evention of yellow 

FEVER. 

By Quitman Kohnke^ M. D., 

Health Officer of the City of Neiv Orleans^ September 
1898 to September 1906. 




The Yclloio Fever Mosquito. 

There can be no yellow fever as a communicable disease 
in the absence of its transmitting agent, the Stegomyia 
mosquito, first classified, entomologically, as culew 
fasciata, then as Stegomyia fasciata, and later as 
Stegomyia calopus. 

,^lhe female only is a blood feeder and disease conveyer, 
the male on account of the peculiar construction of its 
feeding organ being unable to pierce the skin to obtain 
blood. 

The female deposits her eggs on the surface of still 
water, and under favorable conditions, the adult insects 
are developed therefrom in about one week. 

The mosquito may be seen at all hours, but is oftenest 
observed in the morning and the afternoon. It selects 
shady places and avoids sunlight. It is said to be a day 
feeder during the first four days of its existence after 
which time it feeds at any hour of the day or night. It 
may live for several months, and once infected with yel- 
low fever, remains infectious during the rest of its life. 
It is a house mosquito and does not migrate. The possi- 
bility of infectiousness, transmitted to the off-spring 
through the egg, is not yet established. 



1128 

Hibernation of the adult mosquito is supposed by some 
authorities to occur, but has not been actually obserred. 
Hibernation of the egg and the larva is also beliered to 
happen. My obseryations incline me to the riew that 
hibernation is likely in the egg, possibly occurs in the 
larva, but does not take place in the x)upa or adult. 

If hibernation of adults does occur in New Orleans, 
I am of the opinion that infectiousness does not resist 
the changes incident thereto. 

Eecrudescence of yellow fever due to the persistence 
of infectiousness in the mosquito through the period of 
hibernation is held by some observers to account for the 
reappearance of the disease in the summer following an 
epidemic year. The recurrence of yellow fever is more 
likely due to its reintroduction through imperfectly 
guarded channels of entrance or, rarely, to the continu- 
ance of the chain of cases throtigh the winter and their 
increase in number as the warm season favors mosquito 
development. 

Much has yet to be learned of the habits and character 
of tJie ^tegomyia mosquito, and the field of observation 
and research is broad and comparatively new in this 
direction. 

ATe are in j)ossession, however, of the essential facts 
of its connection with yellow fever, and new discoveries 
will be the elaboration of details, corroborating the main 
truth and regulating its precise application in sanitary 
practice. 

II. 

Moral ResponslljUitjj for Epidemics. 

Since the discovery of its mosquito transmission, the 
prevention of yellow fever is a much simpler problem 
than in the days of our ignorance of the mode in which 
the disease invariably spreads from person to person. 
While we have not yet discovered the germ of yellow fever 
or its primal origin, our knowledge of the manner and 



PREVENTION KOHNKE. 1129 

cliaracter of its movement places a formidable weapon in 
our hands against its progress, and it may be said in 
reason and with fairness, that a commnnity suffering a 
yellow feyer epidemic is lacking as a whole in the essential 
characteristics of intelligent manhood. 

Yellow feyer in the ignorant past was a misfortune; 
in the enlightened present it is a fault — in the moral 
future it may be a crime. 

III. 

The Sanitary Creed. 

The doctrine of the mosquito conveyance of yeJiow 
fever, for the practical application of preventive measures 
based thereon, ma^^ be expressed thus : 

The immediate causative factor, the germ cf t-ie i^.s- 
ease, is accessible to the only natural vehicle of transmis- 
sion, the mosquito, during the first three days of the 
fever, and the germ after entering the mosquito's stomach 
requires twelve days to migrate to one of the salivary 
glands, from which the insect, while feeding, may inject 
it into the blood stream of its victim, in whose system 
the period of incubation is usually from three to five days, 
rarely six. 

The human subject of the disease may be consiCLcred 
infectious, therefore, to the mosquito during the first three 
days of the fever, and not thereafter; the mosquito being 
infectious after the twelfth day from the date of inocula- 
tion, and not hefore. Its victim shows the first symptom 
of disease usually in less than five days after infection by 
the insect. 

The exceptions to this rule are not sufficient to suggest 
its modification, but in actual practice the patient is con- 
sidered possibly infectious during four days, and the mos- 
quito possibly dangerous on the tenth day. 

A case of yellow fever cannot occasion another case in 
less time than the period of germ emigration in the mos- 



11 so 

quito, which is twelve days, added to the period of incuba- 
tion in the human victim, which is seldom less than three ; 
fifteen days completing the minimum cycle of infection. 
We may say approximately that explosions of infection 
should be expected, and are observable semi-monthly, and 
the preventive effect, therefore, of disinfection cannot be 
determined earlier than fifteen days thereafter. We can 
not say how many cases may result from one case un- 
treated sanitarily, but we can say positively that no case 
will result if there are no mosquitoes present of the Ste^ 
gomyicb variety. Conversely we may rightly apprehend a 
great infection in the presence of great numbers of 
mosquitoes. 

The application of the mosquito doctrine to the pre- 
vention of yellow fever is all that need be done in any 
emergency ; but to accomplish this, is a problem not to be 
solved by any set formula. It is an easy matter to set 
down on paper and in an office a lot of rules in the abstract 
to be carried out in the field, but it is a different matter 
to apply these rules concretely to actual cases to obtain 
results. 

Circumstances and conditions met with in actual prac- 
tice may radically change the relative value of details, es- 
teemed of paramount importance theoretically. 

As applicable to a locality or community, there may be 
considered three propositions, upon the first two of which 
is based the third, which is offered in the nature of a 
conclusion. 

1. Quarantine against yellow fever cannot be made 
absolute in its protective value. 

2. Early recognition of the presence of yellow fever 
infection is difficult always, and at times impossible. 

3. The most dependable measure of prevention of yel- 
low fever is destruction of the Stegomijia mosquitoes be- 
fore the possibility of infection. 

Quarantine. — In quarantine against yellow fever, two 
essentials are to be considered, and notliincj else. Deten- 
tion of persons exposed to infection for not less than the 
period of icubation of the disease, and the prevention of 
entrance of infected mosquitoes. 



PREVENTION KOHNKE. Sl 1 S.l 

The increasing facility of rapid tray el makes^^'i^uaran- 
tine more difficult and less reliable. However, near to 
perfection may become our maritime quarantine system, 
we shall always be exposed to infection by rapid land 
transportation from ports not themselves infectible, or 
which are less careful for other reasons. Quarantine, 
though important and necessary, cannot ever be all- 
sufficient. 

Early Recognition. — Early recognition of yellow^ fever 
infection, so essential to the prompt application of sani- 
tary remedial measures, is rarely to be expected. The 
history in this respect of 1897-8 and 1899, as well as that 
of 1905, exemplifies this, not only in New Orleans, but 
elsewhere, even in Havana, where better preparation is 
made and better opportunities offer for the prompt 
discovery of early cases. 

We should not relax our constant watchfulness during 
the season of danger, but we must realize that knowledge 
of the existence of first cases requires a combination of 
factors not always obtainable and not within our practical 
control. 

lY. 
Mortality Statistics. 

Three charts of mortality are shown for three separate 
years, one of which, 1905, is a yellow fever year. All the 
charts apply to New Orleans. 

The causes of death are those under which yellow fever 
may be concealed, intentionally or not. 

A careful analysis of these records does not bear out 
the notion, expressed by some, that the presence of yellow 
fever may be discovered early through an inspection of 
the mortality records. In 1905, the presence of yellow 
fever was suspected by the report on the afternoon of 
July 12th, of cases of illness for official investigation. 
Subsequent discovery was made of its probable presence 
as early as the middle of May. If mortality records had 
the value, in this respect, that is claimed for them, then 
those for 1905 would have furnished the warning of 
danger. 



1132 



AUGUSTIN'S HISTORY OF YELLOW FEVER. 



No system of investigation which will seem to discover 
yellow fever in the records of 1905, prior to July 12th, 
will fail to indicate yellow fever also for 1903 and 1904, 
years when yellow fever was not present. 

The value of mortality charts may be historic and cor- 
roborative, but it is certainly not prophetic, in respect 
to yellow fever. Investigations of individual cases, whose 
circumstances, together with the given cause of death, 
may excite suspicion, is more reliable than an observance 
of increased mortality from certain diseases, and is earlier 
available. But this also is not dependable to discover 
early cases, for it was our routine practice during the 
danger period, and was done during the summer of 1905, 
as late as the early part of July, with negative results. 



January 

February ... 

March 

Aprrl 

May 

June 

July 

August 

September 
October ... 
November . 
December . 





3 J 


60 


11 


5\ 


10 


42 


7 


33 


2.5 


48 


116 


44 


91 


3? 


38 


43 


18 


27 


24 


34 


11 


44 


14 


i 46 


?4 



11 

<2 

8 

6 

6 

11 

S?8 

13 

5 

3 



32 

7 
16 
26 
19 
24 
114 
31 
26 
1-2 
16 
11 



904. 



Mfi 



to 

•t: ^^ 

(D C 
-Ml-, O 
CP &: 






(C.S 

(B O 

P3 p, 



January .... 
Februarj' . 

March 

April 

May 

June 

July 

August 

September 
October .... 
November 
December 



38 
40 
41 
37 
3-2 
42 
42 
25 
32 
47 
42 
56 



9 
3 

16 
80 
70 
30 
40 
22 
19 
17 
16 
12 



16 
15 

8 
18 
28 
28 
45 
58 
37 
26 
26 
31 



PREVENTION KOHNKE. 



1123 



1903. 



5 

'u 


Acute 
Nephritis 




Enteritis 

Under 
Two Years 


1-1 


rt p. 


3 


4 


53 


13 


5 


16 


1 


7 


53 


12 


4 


8 


4 


2 


53 


10 


6 


13 


2 


5 


39 


20 


6 


13 


9 


5 


41 


82 


8 


28 


11 


5 


30 


73 


IH 


55 


10 


3 


39 


56 


16 


59 


9 


3 


51 


26 


21 


79 


8 


3 


54 


11 


14 


66 


11 


7 


51 


17 


8 


25 


10 


6 


49 


18 


2 


24 


3 


5 


50 


17 


11 


96 



January 

February .. 

March 

April 

May 

June 

July 

August - .. 
September 
October ... . 
November 
December 



Y. 



Destruction of Stcgomijiae. 



Finally, we must, I think, conclnde that the de- 
struction of the only transmitting medium is tlit) 
surest preyentiye of yeiloyr feyer. This measure 
also is subject, of course, to imperfect application 
in practice, and incomplete results. It is, for this reason, 
not sufficient, alone, to guarantee against infection, but 
it offers the important element of time during which to 
arrange for and encourage its thorough a^jplication ; and 
in the eyent of the failure of quarantine and of the prompt 
recognition of infection, the spread of the disease is modi- 
fied by eyen a partial destruction of the conyeying medium, 
and this giyes opportunity for perfecting organization 
against the infected insects. 

The health authorities of New Orleans were conyinced 
of the truth and importance of the mosquito doctrine of 
yellow feyer conyeyance, in 1901, and of the importance 
of mosquito destruction. Twice a law such as is now 
operative was proposed to and rejected, by the city 
council, and my belief is now, as it was then, thati the de- 
struction of ^tegomyia mosquitoes prior to the introduc- 



1134- AUGUSTIn's HISTORY OF YKLLOW FEVER. 

tion of yellow fever is the ounce of preyentiou that is 
better than the pound of cure. 

VI. 

Conditions Obtaining in New Orleans in 1905. 

The explosion of infection in New Orleans in 1905, was 
due to an unfortunate combination of unfavorable con- 
ditions, to which was applied the spark of introduced in- 
fection. How the fever entered the city is not the offlcial 
concern of the health officer, who is specially denied by 
law any function or authority in maritime or inland quar- 
antine. When the fever got here, however, it found ideal 
factors for its development and spread. The section of 
the city first infected is the most densely populated. The 
people are for the most part ignorant of our language and 
illiterate in their own. Their habits are unsanitary and 
their customs such as tend to secretiveness and improvi- 
dence. They are not, as a rule, vicious, but fearful of 
police authority, and exceedingly clannish; as is not un- 
natural for foreigners in a strange country. 

It is currently believed, and I think correctlj^ so, that 
among them are criminals escaped or deported from their 
own country ; and that the ''dago vote," as it is called, is a 
political factor of considerable importance in that section 
of the city. 

Medical attention in case of illness is usually delayed 
until the severity of symptoms demands it, and any but 
severe ailments are likely to be followed by recovery with- 
out medical interference. They are attended when ill, 
mainly by physicians of their own nationality, not all of 
whom speak our language and some of whom are un- 
familiar with yellow fever. They are apt to resent the 
reporting of any case of communicable disease to the 
authorities, and are likely to dismiss the attending physi- 
cian for this reason. Imagine a crowded population of 
this kind whose water supply consists in large part of 
turbid river water, kept for settling purposes in numerous 



PROTECTION KOHNKE. 1135 

open barrels, each one an ideal breeding place for the 
Stcgomyia mosquito. 

For more than four 3^ears the health offlcer, encouraged 
and supported by the board of health, had pointed out the 
danger ; had explained, urged, begged and prophesied, but 
other considerations were deemed of greater importance 
than the destruction of mt)squitoes. In plain English, 
the politicians thwarted the designs of the health officer 
while the general public was indifferent. 

When the disaster came, however, the people of New 
Orleans, awakened from a lethargic sense of security, rose 
to the situation and demonstrated their willingness and 
ability to fight the greatest battle that was ever waged 
against yellow fever; and they conquered. / The united 
forces of the combined authorities of the City, State 
and Nation and the whole people of New Orleans, men 
and, notably, women succeeded in turning a great calamity 
into the most glorious victory of modern times. For the 
first time in New Orleans an epidemic of yellow fever was 
fought with the weapons suggested by the doctrine of 
mosquito conveyance of the disease, and for the first time 
extensive yellow fever infection was controlled as early as 
August. 

The successful efforts of the local authority were dis- 
turbed by internal bickerings, jealousies and political 
intrigues which endangered the final outcome, and the 
Federal government was a^Dpealed to and invited to as- 
sume charge of the situation. This was done through the 
Marine Hospital Service by the enabling authority of the 
health officer and the victory was continued to completion. 

The first victory over yellow fever was in Havana, the 
greatest in New Orleans. 

The character of the neighborhood first infected, its 
nearness to the landing place of the Havana steamers, the 
intimate connection of the people with the tropical fruit 
trade, and the facility with which infection could have 
gotten, and probably did get, to the luggers, the landing 
place for which is in close proximity, these luggers being 
connecting links with the .2:ulf coast of Louisiana, are- 



1136 AUGUSTIN S HISTORY OF YELLOW FEVER. 

suggestive; and give occasion for various speculations, 
with regard to the mode of origin and source of infection, 
not likely at this time to reach the domain of ascertained 
facts. 

Suspicion was specially directed to this neighborhood 
of the city about the middle of July, but subsequent 
knowledge indicated the real beginning of yellow fever 
infection to have been probably six or eight weeks earlier ; 
thus allowing infection to reach other sections of the 
State before the suspicion of its presence was excited in 
New Orleans. 

Never before was an epidemic of yellow fever in New 
Orleans fought in the same way, and the most skeptical 
of reasonable persons must conclude that the control of 
what would have been one of the greatest of yellow fever 
epidemics was due solely to the prevention and destruction 
of mosquitoes. 

VII. 

Conclusions. 

Since the Stegomyia mosquito alone transmits yellow 
fever, preventive measures need be directed only against 
this insect, and since the adult mosquito of this variety 
issues in about one week after the egs^ is deposited upon 
the surface of still water, the following rule should be 
enforced^to render a locality immune to the disease. 

Once a week pour upon the the surface of all still water, 
not removable by drainage or otherwise, or stocked with 
fish, or screened from mosquitoes, a quantity of refined 
kerosene equivalent to one ounce for each ten square feet 
of surface. 

This, if begun before their fiight, will prevent the breed- 
ing of Stegoimyia mosquitoes, and thereby remove 
the possibility of spreading infection which they alone 
can spread. 

;AJ loeality so protected against yellow fever need not 
quarantine against the disease, but protection so obtained 



PREVENTION KOHNKE. 1 1 S7 

can not be more complete than the work is thorough, and 
the work will not be more thorough than the people are 
informed. 

If quarantine be advisable, because of infectibility, this 
measure of protection need only include persons ex- 
posed to infection, (and these should be detained only 
during the period of incubation of the disease) ; and need 
not include any article, incapable of transporting 
mosquitoes. 

An infectible locality is one containing adult Stegomyia 
mosquitoes, and, should the disease be introduced, f\imi- 
gation to kill possibly infected mosquitoes must be prac- 
ticed in infected domiciles, and for this the location of 
early cases is necessary. 

It is my experience that early cases, not imported, are 
not recognized in time to prevent infection, a;nd it is 
my belief that they never will be. Diagnosticians who can 
at all times differentiate between the very mild cases of 
yellow fever and diseases resembling it exist mainly in 
the imagination of the laity. / 

Ignorance and improvidence have permitted variola to 
exist more than a hundred years after the discovery of its 
prevention. Ignorance, improvidence and commercial 
greed may permit yellow fever to be occasionally epidemic 
in our country for an equal period. 



1138 

BIBLIOGRAPHY OF TRANSMISSION OF YELLOW FEVER BY 

MOSQUITOES. 

(Compiled br George Augustin.) 

Agramonte (A.): An account of Dr. Louis-Daniel Beauperthuy, a 
pioneer in yellow fever researcli. Boston M. & S. J., 1908, vol. 158, 
p. 927. 

Algomdona (M. S.) : (Etiology.) Rev. Med. de Bogota, 1907-8, vol. 
27, p. 41. 

Aubert & Guerin: Note sur la capture, a Marseille, d'un moustique 
du genre Stegomyia. Compt. Rend. Soc. de Biol., Par., 1908, vol. 64, 
p. 378. 

Beauperthuy (Louis-Daniel) i Gaceta Official de Cumana, Ano 4, Xo. 
57, May 23, 1854. (See also article by Agramonte.) 

Blanchard (R.) : Les Moustiques. Paris, 1905. 

Bonneloy: Fie\T:"e Jaune Experimentale. Archives de Med. Xav., 
Paris, 1907, vol. 88, p. 283. (2 charts.) 

Bouffard (G.): Le stegomyia fasciata au Soudan francais. Bull. 
Soc. Path. Exot., 1908, vol. 1, p. 454. 

Brumpt (E.) : La fievre jaune, Presse Med., Par., 1908, vol. 16, 
p. 731. 

Campo (G.) : L'epidemia di febbre gialla del 1905 nel territorio 
meridionale degli Stati Uniti d'America ed i criterii di profilassi che 
ne derivano. Ann. di Med. Xav., Roma, 1908, vol. 1, p. 153. 

•Carbajal (A. J.) : Etiologia de la fiebre amarilla o vomito prieto 
considerada desde el punto de vista de su transmision por la picadura 
del mosquito. Bol. d. Inst. Patol., Mexico, 1907-8, 2. ep., vol. 5, pp. 
521, 589, 657. 

iCarbajal (A. J.) : La etiologia del vomito o fiebre amarilla. Mem. 
Soc. Cient. "Antonio Alzate," Mexico, 1907-8, vol. 26, p. 81. 

Carroll (J.): A brief review of the etiology of yellow fever. X.. Y. 
Med. Jl., (etc.) 1904, vol. 79, p. 241. 

Carroll, J.: Discovery of the Transmission of Yellow Fever by the 
Mosquito. American Medicine, 1904, vol. 8, p. 583.. 

Carroll (J.) : The etiology of yellow fever. J. Am. Med. Assn., 
Chicago, 1903, vol. 41, p. 1341. 

Carroll (J.): Historj-, Cause and Mode of Transmission of Yellow 
Fever. Journal Association of Military Surgeons, 1903, vol. 13, p. 177. 

Carroll (J.) : Remarks on the history, cause and mode of transmis- 
sion of 3'ellow fever, and the occurrence of similar types of fatal 
fevers in places where yellow fever is not known to have existed. J. 
Ass. Mil. Surg. U. S., Carlisle, Pa., 1903, vol. 8, p.. 177. 



TRANSMISSION BY MOSQUITOES BIBLIOGRAPHY. 1 139 

Carrol (J.) : Transmission of Yellow Fever. Journal American 
Medical Association, 1903, vol. 40, p. 1429; 1903, vol. 41, p. 43. 

'Carroll (J.) : Without Mosquitoes * * * no Yellow Fever. Science, 
(new ser.), 1905, vol. 23, p. 401. Also in American Medicine, 1906, 
vol. 11, p. 383. 

Carter (H. R.) : A note on the spread of yellow fever in houses; 
extrinsic incubation. Medical Record, 1901, vol. 59, p. 933,. 

Carter (H. R.): T'he conveyance of yellow fever. Rep. Surg.-Gen. 
Pub. Health .& Mar. Hop. iServ,, U. S., Wash., 19(>4i, p. 436. 

Also: Texas Med. Gaz., 1904, vol. 4, p. 172. 

Also: Med. News, N. Y., 1904, vol. 85, p, 878. 

Carter (H. R.): A correlation of some facts in the propagation of 
yellow fever, with the theory of its conveyance by the culex fasciata. 
Phila. Med. Jl., 1901, vol. 7, p. 694,. 

Carter (H. R.) : Some characteristics of stegomyia fasciata which 
affect its conveyance of yellow fever. iMed. Rec, N. Y., 1904, vol., 65, 
p. 761. 

Carter (H. R.) : The Methods of the Conveyance of Yellow Fever 
Infection. Yellow Fever Institute 'Bulletin, No. 10, 1902 (Revised in 
report of t'he Superviising Surgeon General, U. S.., 1904, p. 436.) 

Also in Medical News, 1904, vol. 85, p. 878. 

Chabassu: Quelques Considerations sur TEtiologie et la Therapeu- 
tique de la Fievre Jaune. L'lJnion Medicale, Paris, 1863, vol. 17, p. 339. 

Chaille (S. E.) : The 'Stegomyia and Fomites. Journal American 
Medical Association, 1903, vol. 40, p,. 1433. 

Chantemesse (A.) and Borel (F.) : Fievre jaune et mostiques. Bull. 
Acad, de Med., Par., 1905, 3. s., pp. 99, 125, 150. 

Chassaignac (Charles) : The Role of the Mosquito in the Propagation 
of Disease,. (Annual Address as President of the Louisiana State 
Medical Society, 1904-05). No. O. Med i& Surg. Jl., 190'5, vol. .58, p. 33. 

Cilo (B. A.): El mexococcidium stegomyiae; parasito de la fiebra 
amarilla. 'Semana Med., Buenos Aires, 1903, voL lO, p. 1242. 

Cobb (J. O.) : Conveyance of yellow fever infection. Phila,. Med. Jl., 
1900, vol. 6, p. '993. 

Corre (A.): Revue critique sur une nouvelle theorie pathogenique 
de la ifievre jaune. Arch, de Med. Nav., Paris, 1883, voL 39, p. 67. 

de Andrade (N,) : Estudio critico sobre la etiologie y profilaxia de 
la fiebre amarilla. Semana Med., Buenos Aires, 1904, vol. 11, p. 740. 

de Gouvea (H.) : Les moustiques et la fievre jaune. Bulletin 
Medical, Paris, 1901, vol. 15, p. 870. 

de Lecerda (J. B.) : Os mosquitos transmissores da febre amarella. 
Braz. Med., Rio de Janeiro, 1901, vol. 15, p. 281,. 

Deshayes (C): Fievre jaune et mostiques, reglements sanitaires. 
Normandie Med. Rouen, 1905, vol. 20; p. 172. 

Carter (H. R.): A note on the interval between infecting and 
secondary cases of yellow fever, etc. N. O. Med. & Surg. Jl., 1900, 
vol. 52, p. 617, 



1 1 40 augustin's history of ycllow feyer. 

de Ybarra (A. M. F.) : The transmission of yellow fever. Lancet, 
London, 1903, vol. 2, p. 1050. 

. Doty (A. H.) : Regarding the Infectious Agent of Yellow Fever. 
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1142 augustin's history of yellow fever. 

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TRANSMISSION BY MOSQUITOES BIBLIOGRAPHY. 1143 

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Marchoux, Salimbeni, and Simond: La Fievre jaune. Rapport de la 
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Merrins (E. 'M.) : The propagation of yellow fever. Medical Record, 
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Clinic, 1'901, n. s., vol. 48, p. 271. 



1144 AUGUSTIN S HISTORY OF YELLOW FEVER. 

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by the mosquito,. N. Orl. M. & S. JL, 190i5^6, vol. 58, p. 326. 



TRANSMISSION BY MOSQUITOES BIBLIOGRAPHY. 1145 

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gation of yellow fever. Phila. M. J., 1901, vol 8, pp. 189, 193. 

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Also reprinted in pampJilet form. 

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114-6 augustin's history of yellow fever. 

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Assn., Chicago, 1903, vol. 41, p. 505. 



1147 

PATHOLOGY OF YELLOW FEVEE. 

BY OLIVER L. POTHIER^ M. D.^ 

Pathologist to Cliarity Hospital, New Orleans. 

Difficulty of Pathological Diagnosis. 

The pathology of yellow fever, like the clinical aspect 
of the disease, is dependent upon a number of factors 
which must be taken collectiveh^, to establish the lesions 
of the infection. It could be embodied in a very few 
words by describing it as a general steatosis. No other 
infection produces such intense and widespread fatty 
degeneration as yellow fever. The sudden and general 
hemorrhages apj)earing during its course are due to the 
fatty degeneration of the endothelium. Yet there is not 
a single lesion of any organ which can be considered 
pathognomomic of yellow fever. It is the collective 
lesions and general pathological picture presented during 
the course of the infection and at the autopsy, which char- 
acterizes the disease. 

We do not find, as in typhoid fever, typhus and other 
infectious diseases, characteristic lesions localized in 
special organs. The lesions of yellow fever are dissemi- 
nated throughout the body, and it is the peculiar general 
picture presented by the lesions of the different organs, 
associated with the history of the case, which makes up 
the basis of a pathological diagnosis. The lesions are 
characteristic in that they affect certain organs, while 
others remain apparently free. ' 

Yellow Color. 

To one familiar with yellow fever, the ax)pearance of 
the body brings to his mind a number of features, which, 
though not absolutely characteristic, present an ensenMe 
on which at times a diagnosis may be based. The body 
presents a yellow color, not the light or lemon color of 
ordinary jaundice, but a decided uniform deep orange 
yellow, which with the peculiar lividity generally exhib- 



1148 AUGUSTIn's HISTORY OF YELLOW FEVER. 

ited by the bodies, gives them a rather striking appear- 
ance. On the chest, neck, genitals, and, at times, other 
parts of the body, not necessarily the dependent parts^ 
are found number of small or large hemorrhagic areas, 
which appear to be cutaneous and subcutaneous hemor- 
rhages. The dependent parts show as a rule marked post- 
mortem hypostasis. The sclera are markedly yellow and 
frequently show hemorrhagic points; the pupils are 
usually dilated. 

Hemorrhagic ^pots. 

In a number of places the subcutaneous tissue show 
hemorrhagic areas, due to overdistention of the capillaries 
of the part, with rupture resulting from the fatty degen- 
eration of the endothelium. In some cases these hemor- 
rhages are numerous and quite extensive. The skeletal 
muscles do not present any marked changes, though, at 
times, areas of fatty degeneration are found. This, how- 
ever, is unusual. 

TJie Lungs. 

The lungs do not present any special lesions. They 
generally appeajc^normal. The microscopical picture may 
show slight engorgement, but nothing else of note. In 
their report on yellow fever Marchoux and Simond state 
that the oedema frequently existing in autopsies of yellow 
fever, is possibly due to post-mortem changes. I must 
say that my experience with yellow fever, prompts me to 
agree with their statements, and that I have generally 
observed that the lungs show very few, if any, changes. 

The Heart. 

The heart and large vessels at its base show frequently 
hemorrhagic spots over their surfaces. The heart is 
usuall flabby, and of a yellowish-red color. The endo- 
cardium frequently shows hemorrhagic spots also. The 
organ may present all of these lesions in a marked degree, 



PATHOLOGY POTHIER. 1149 

or one lesion may be more pronounced, while the others 
do not show. Again the organ may not show any lesions. 
It is rare, however, that one or the other lesions are not 
apparent. The microscopical examination may reveal at 
times marked latty degeneration, Avhile at others the 
muscle is normal. 

The Liver. 

The lesions of the liver are more frequently met with 
and are more characteristic, the organ presenting in typi- 
cal cases a marked fatt^^ degeneration. It has a yellow 
cast, though I cannot say that it is always boxwood in 
color. At times it may exhibit that appearance, but in 
the majority of instances the organ is simply yellowish. 
The microscopical ajDpearance in cases that die early 
show fatty degeneration of the middle part of the lobule, 
'or in what is known as the hej)atic artery zone. This 
appearance does not show, however, in cases that die after 
the fiflth or sixth day of the disease, as the fatty degenera- 
tion has involved all of the lobule. In these cases 
the organ is transformed into a mass of fatty degenerated 
cells, little if any of the protoplasm of the cells remaining, 
while the blood capillaries and spaces are filled with 
blood. 

The early fatty degeneration as described above, limited 
to the middle zone of the lobule, is considered by some 
as characteristic of yellow fever ; but it is found in other 
infectious diseases, and is rather a characteristic of the 
fatty degeneration of acute hepatitis of infectious diseases. 

The Spleen. 

The spleen does not show anything of note, and is gen- 
erally normal in size. This is a differential point between 
yellow and malarial fevers. The spleen in the latter al- 
ways presenting the characteristic appearance of malaria. 
The microscopical examination fails to shoAv anything, but 
at times one may find a large quantity of blood in the 
blood spaces, with fatty degeneration of endothelium. 



1150 augustin's history of yellow fever. 

The Kidneys. 

The kidneys are usually of a reddish-yellow color, and 
appear congested. On section the organ presents a 
marked yellow color, mixed with red and frequently small 
hemorrhagic areas are disseminated through the substance 
of the organ. In some cases, however, this organ may not 
show any apparent lesions. The microscopical appearance 
is generally that of an acute parenchymatous nephritis, 
with extensive fatty degenerations, the cells of the tubules 
appearing as granular masses lining the tubules and filled 
with fat droplets. The cells or what remains of them are 
desquamating and in many areas casts are found plugging 
the lumen of the tubules. The capillaries are filled 
with blood and in places blood is found in the connective 
tissue and at times in the tubules. In some cases, hardly 
any lesions can be demonstrated, with the exception of a 
few fatty cells. 



The Adrenals^ Thyroids and Pancreas. 

The adrenals thyroids and pancreas all present fatty 
degeneration of their respective epithelium. The degen- 
eration in the adrenals seem to be more marked in the 
zona fasciculata. All of the different organs present fatty 
degeneration, which seems to be the main lesion of yellow 
fever. 



The Stomach. 

The stomach mucous membrane presents hemorrhagic 
spots, more especially near the cardiac extremity. The 
contents are of a semi-fluid or fluid dark-grumous color, 
or the viscus may be empty. The microscopical examina- 
tion reveals a swollen mucosa; the cells are desquamating 
and fatty, the fatty degeneration extending to the gland- 
ular cells even in the fundus of the glands. 



PATHOLOGY POTHIER . 1151 

The Intestines. 

The small and large intestines, if we except the begin- 
ning of the duocleum, do not present very much of note 
microscopicallY. Under the microscope we may find in 
the small intestines a swollen mucosa., the cells of which 
are desquamating and, occasionally, a few fatty cells ; but 
these lesions are not constant. At the beginning of the 
duodenum, the first two inches present very much the sa^ie 
lesions as those of the stomach. 

The I^lood. 

The blood of yellow fever does not present much of 
note. The repeated examination of this tissue has failed 
to reveal anything definite. Some cases present appar- 
ently an increase of the platelets, but this is not a con- 
stant condition and cannot be considered typical of the 
disease. Again certain bodies have been reported as oc- 
curring in the plasma, but it is very probable that they are 
due to fragmented corpuscles or some artefact, and are 
not constant. The blood count is practically normal and 
there does not seem to be any constant variation in the 
amount of hemoglobin, though at times a series of cases 
may show a slight diminution. Taken as a whole in a 
large number of cases the blood alteration are practically 
nil. The leucocytic count is also normal, and there does 
not seem to be a preponderance of either class of leuco- 
cytes. In the microscopical examination of organs, one 
is at times struck with the number of leucocytes carrying 
fat globules, or it may be undergoing fatty degeneration. 

' The Nervous System. 

The central nervous sj^stem sho^^s lesions which are 
practically the same as that of the other organs. Fatty 
degeneration, may be present, though probably not as 
extensive nor as intense. The surface of the organ is gen- 
erally congested and the centrum ovale shows a number or 
punctiform red areas, showing dilation and congestion of 



1152 augustin's history of yellow fever. 

the blood ressels. The surface and even the white substance 
of the brain may show numerous small hemorrhages. 
These are the most aj^parent gross lesions of the nervous 
system ; though at times >theT are not noticeable. The 
microscopical examination of the different ganglionic 
areas of the organ shows fatty degeneration of ^he nerve 
cells, all of which seem to be susceptible to the toxic in- 
fluence of the infection. The cells of Purldnje, accordii:5;' 
to Marchou and Simond, are less vulnerable. 

The spinal cord present the same general lesions found 
in the brain. 

Adults More Susceptible. 

We must not forget that the majority of fatal cases 
of yellow fever occurs in adults, and that these may show 
lesions of previous diseases, and these lesions must not 
be looked upon as forming part of the pathology of yellow 
fever. Frequently the spleen of yellow fever cases is 
found enlarged and shows evidence of malarial infection 
previous to the yellow fever which caused the death of 
the case. Cirrhotic conditions of the liver are also fre- 
quently found, as well as the small granular kidney of 
chronic interstitial nephritis. 

In fact all of the organs may present lesions which 
antedated the attack of yellow fever. It is a question 
whether we would have as many deaths from yellow fever, 
if the patient's organs were healthy previous tO' the occur- 
rence of yellow fever. For it is remarkable how rarely 
children or young children die of yellow fever. In fact 
in them the disease is so mild as to pass unnoticed by the 
best experts on yellow fever ; a fact noted by all who have 
seen yellow fever and who have written on the subject. 
It is possible, however, that children are less susceptible 
to the poison. 

General Steatosis the only Special Characteristic Lesion. 

Before concluding this subject I wish again to impress 
that there is no special characteristic lesion of any organ 



PATHOLGY POTHIER. )15S 

upon which we can base our diagnosis at autopsy. The 
general steatosis of practically all the organs, more or 
less marked in all of them, is the only constant lesion, 
and that it is the general picture presented by this char- 
acteristic associated with the clinical history of the case 
which enables us to make a positive diagnosis of j^ellow 
fever. 



1154 

DIAGNOSIS OF YELLOW FEYER. 
By HAMILTo^' P. Jones, M. D., Xew Orleans. 

Resident Physician Isolation Hospital^ Xew Orleans, 1897; 
Chief Surgeon Jones [Yellow Fever Hospital, Santi- 
ago de Chiha, 1898, U. S. A.); Physician-m-Chief 
Emergency Hospital, Xew Orleans, 1905. 

The diagnosis of yellow fever is perhaps one of the most 
difficult of all to make with certainty in the early stages 
of the disease, and there are probably many light cases 
of this disease not recogn^'zed at all, and during epidemics 
a great many diagnosed as such that are not. 

Most careful study, scientific observation and post- 
mortem of all of the cases in the Isolation Hospital ( Xew 
Orleans, 1897), in the Jones Yellow Fever Hospital (San- 
tiago de Cuba, 1898), and the Emergency fiospital (Xew 
Orleans, 1905), all of which I had charge, and in which 
over a total of a thousand cases were treated, convinced 
me that not less than ten per cent, of the cases sent into 
these yellow fever hospitals did not have the disease. 
These institutions were all established with the primary 
end in view of protecting the communities from the in- 
fection, and for the treatment of yellow fever only, and in 
many instances police power had to be exercised to force 
indigent or unruly patients into them. It is natural to 
suppose that no such extreme steps would be taken until 
the physicians had convinced themselves of the truth of 
their diagnosis. If ten i)er cent, are sent into hospitals 
wrongly diagnosed, it is reasonable to suppose that at 
least ten per cent, escape diagnosis at all. This, it will be 
seen, still leaves the number of reported cases in any given 
outbreak approximately the correct number. 

It, therefore, becomes imperative that the physician 
take every precaution for the community, by not being too 
sure of himself, but very sure of his screens for the first 
four days of any fever that might be confounded with this 
disease. While there is no doubt in my mind that the 
moscjuito is the medium of conveyance of yellow fever 



DIAGNOSIS JONES. 1155 

from man to man, and that the infected mosquito may pos- 
sibly be carried greater or less distances to accomplish 
this, yet the history of all outbreaks are traced to the im- 
portation of some human being sick of the disease, upon 
Avhom the local mosquitoes feed and become infected. 

With this important fact in mind, it, therefore, becomes 
imperative to get an absolutely correct history of the 
patient's moyements for at least ten days prior to being 
stricken down, and equally important to determine his 
haunts, the localities whence his associates have come, 
and whether or not there has been sickness among them. 
Equal in importance with the above as an aid to diagnosis, 
is a careful medical history of not only the present attack 
but the medical history of his whole life, personal habits 
and environment, all of which if known might help to 
clear up an awkward situation; for instance, history of 
gall stones, cirrhosis of the liver, with repeated attacks 
of albuminuria and jaundice, etc. 

Unfortunately there is no cardinal symptom of yellow 
fever, nor any two or three symptoms that may be taken 
as pathognomic at any one stage of the disease. The pic- 
ture is a complex one, gradually unfolding itself. In mild 
cases all symptoms may be so light as to escape all but the 
most careful scrutiny, while in severe cases so pro- 
nounced as to almost stamp the diagnosis on the body and 
face of your patient. Persons ill with yellow fever always 
say that they are very sick and always, no matter how 
light the case may be, give the attending physician that 
impression. 

Yellow fever, in common with such contagious diseases 
as smallpox, measles and scarlet fever, occurs as a gen- 
eral rule, but once during life, differing from them, how- 
ever, in that it has never been known to propagate beyond 
48° north and 38° south latitude, nor below a temperature 
of 65° farenheit, corresponding to the possible geographi- 
cal distribution of the stegomyia calojms and its temera- 
ture of activity; the disease sparing neither age nor sex, 
only those being exempt from its influence who have at 
some former time had it. Its attacks are confined neither 
to the night nor day, nor to any state of the system. 



1156 AUGUSTIX'S HISTORY OF YELLOW FEVER. 

whether of fasting or feasting, of plethora or anaemia, of 
robust health or chronic disease. 



First Stage. 



Yellow fever presents two well defined stages : 
First stage. — This is characterized by severe pains in 
the head, confined chiefly to the eyes and forehead, back, 
lower extremities and epigastric region, with increase of 
pain and tenderness over the liver on pressure, a i)eculiar 
siiining or drunken appearance in the eyes, rapid circula- 
tion, and marked peripheral venous stasis and elevated 
temperature. It more often attacks those who are appar- 
ently in perfect health ; they are seized with intense head- 
ache, chill, shivering pain in the limbs and back, followed 
by rai3id elevation of temperature, increased action of the 
heart, animated congested countenance, red. glistening, 
suffused eyes, congestion of gums, as a rttle, but not 
always ; intense thirst, anorexia, uneasiness of the epigas- 
trium, nausea and vomiting. This stage may extend from 
36 to 150 hours without any distinct remissions, according 
to the severity of the disease. 



Second Stage. 

Second stage. — This is characterized by depression of 
the nervous and muscular systems, and of the general and 
capillary circulation; capillary congestion more marked; 
slow and intermittent pulse; jaundice, albuminous urine 
loaded with granular casts and debris — always bile — 
stained. In more marked cases some, or all of these addi- 
tional symptoms may appear : A purplish and yellowish 
mottled appearance of the surface, urinary suppression, 
passive hemorrhages from the ears, stomach and bowels, 
gums, nose, tongue, uterus, vagina, gall bladder and antis ; 
black vomit, interstitial hemorrhages, delirium^ convul- 
sions and coma. 



DIAGNOSIS — JONES. 1157 

The Blood, 

The blood in yellow fever lias not shown any charac- 
teristic of the disease, except that it seems to be more 
concentrated than normal, all the various cells being- 
found, in uncomplicated cases, in otherwise healthy in- 
dividuals, in slightly greater numbers than in health, but 
in proper ratio with probably more platelets than normal. 
Hemoglobin percentage is always high in simple uncom- 
plicated cases of yellow fever, 100 per cent, and over. 

Urine. 

Albumin is an invariable constituent of the urine at one 
time or another during the course of yellow fever, ranging 
from a trace to 80 per cent, moist. Casts, renal epithelium, 
and debris, always bile-stained, and other evidences of an 
acute inllamation of the kidneys present in a great 
majority of all cases. In several instances the finding of 
casts and debris not bile-stained led me to suspect that 
the patient was not sutfering from yellow fever, but from 
some other disease associated with kidney troubles, and 
subsequent developments confirmed the suspicion. One 
would naturally expect in the early stages of yellow fever, 
in a person already suffering from a cast producing dis- 
ease of the kidneys, to find casts not bile-stained, but they 
would as the disease progressed become so stained. In 
any other condition of the system associated with casts 
and bile pigments in the urine, we would expect to, and 
have found, the casts and debris bile-stained. 

I consider this observation of the greatest importance 
in the differential diagnosis of yellow fever. 

Facial Expression. 

There is a peculiar facial expression in yellow fever, 
brought about by the combination of the flushed and con- 
gested face and eyes and the underlying tinge of yellow 
that is quite characteristic of the disease. 



1158 augustin's history of yellow fever. 

Jaundice. 

Early in the onset, while congestion is still active, 
blanching the lips or skin will reveal jaundice of the skin 
and mucous membranes. Jaundice usually develops rap- 
idly and is well marked by the time the congestive stage 
has subsided. 

Circulation. 

The venous statis is an important sign, and while not 
peculiar to this disease, is more or less well marked in all 
cases, the mark left by pressing with the finger on the 
cheek taking an appreciable time to return to the color 
of the surrounding tissues, from a few seconds to a minute 
or more, depending on the stage of the case and its 
severity. 

Temperature. 

The temperature in yellow fever is continuous, lasting 
from 24 to 150 hours. There may be a period of calm 
lasting a few hours, followed by a secondary rise; this is 
a septic fever, of colon bacillus origin. >Yellow fever it- 
self is a fever of one paroxysm only, but opens the way 
for many secondary infections, evidenced by furunculosis, 
parotiditis, carbuncles, etc. Cases having a temperature 
above 102^2 degrees farenheit, are severe, and on the ap- 
proach of death the temperature may go to 106 or 107, con- 
tinuing to rise after death for hours, sometimes reaching 
the extraordinary height of 112 or 114, a condition not 
often noted in other diseases, except sometimes in sun- 
stroke and injuries or diseases, affecting seriously the 
central nervous system, as abscess of the brain, apoplexy, 
etc. 

Pulse. 

The pulse during the onset of the attack is rapid as a 
rule and fairly full and strong, the rapidity, however, 
rarely corresponding to that found in other diseases with 



DIAGNOSIS JONES. 1159 

an equal temperature. It frequently happens, however, 
that the pulse may never go above 100, no matter how 
high the temperature goes. Cases vary in this respect 
very much. As a general rule there is lack of correlation 
between the pulse and temperature, frequently the pulse 
becoming slower while the temperature continues to rise. 
Even where there is correlation between pulse and temper- 
ature in yellow fever, the pulse and temperature going up 
and down together, the pulse is usually from fifteen to 
thirty beats per minute less than would be found in other 
diseases. 

As the pulse in yellow fever falls, it becomes weaker, 
softer and more or less irregular as to time and strength 
of beat, and often intermittent. In fact so true is this 
that the attention of the attending physician may be 
drawn to the possibility of the presence of yellow Dever 
by the character of the pulse of other members of the 
household who give a recent history of some undetermined 
sickness. This is particularly valuable in the lighter cases 
of children. This slowness and irregularity of the pulse 
may last from a day or two to several weeks. 

Respiration. 

Respiration in yellow fever is rarely affected unless 
there is some intercurrent disturbing factor. 

Blood Pressure. ^ 

Blood pressure is almost uniformly low in yellow fever. 
At the onset of the disease it may be hi2^her than normal, 
but as the disease progresses, usually by the end of the 
second day it has fallen below 120 m.m. of mercury, with 
a Riva Rochi Sphv2:manometer 16 cm. bag, and may sfo 
below 70 m.m'. This low blood pressure is a valuable 
sign of this disease and seems almost tO' be a conservative 
protective step taken on the part of nature, and the blood 
pressure observations made at the Emergency Hospital, 
!N'ew Orleans, 1905, threw important and interestins: lisjht 
on certain phases of the disease not before understood. 



1160 AUGUSTIN'S HISTORY OF YELLOW FEYIR. 

In order to bring mv ideas out more cleariT on this 
phase of the disease, it will become necessary for me to 
digress from the diagnosis for a moment. 

One of the most lironounced effects of the yellow fever 
toxin is the profound fatty degeneration of every organ 
and structure of the body produced. Even the epithelial 
cells and muscles of the deep urethra are affected. The 
effect of this fatty degeneration on the heart muscle is 
to weaken its action. The effect oi* this fatty degenera- 
tion on the blood vessels and capillaries is to impair their 
strength, and render stasis and hemorrhages, particularly 
caijillary, more easy to ijroduce. When a patient becomes 
frightened, delirious, unruly or through ignorance gets up 
and exerts himself, the disastrous and oftimes fatal con- 
sequences are brought about by the increased heart action, 
and consequent increased blood pressure, causing rupture 
of the weakened and degenerated smaller blood vessels, 
producing hemorrhages into the meninges and gastro in- 
testinal mucous membrane, causing delirium, convulsions, 
black vomit, hemorrhages from the bowels, uremia and 
frequently death. The fatal eff'ects of over-eating are due 
to the increased blood pressure, produced by the meal. A 
rapid pulse and high blood pressure, either singly or to- 
gether, are of the gravest import in yellow fever. From 
my observations it would appear that the crossing of blood 
pressure and pulse lines does not have the same sinister 
significance that the crossing of the temperature and pulse 
lines has in the chart; however, it is not altogether fav- 
orable for it to do so. 

In reference to the degeneration of the blood vessels, I 
have noted that yellow fever patients are more easily 
bruised, and that hypodermics are more liable to produce 
subcutaneous abscesses and sloughs than in most other 
diseases. 

B ifferentia J D lagn osis. 

The follov-ing diseases may cause difficulty in making a 
differential diagnosis : 

Malaria. Yellow fever may be mistaken for certain 
unusual forms of malarial fever. Microscopical examina- 
tion of the blood, and the use of quinine will usually clear 



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DIAGNOSIS JONES. 1161 

up this diagnosis, however, it is perfectly possible to have 
yellow fever and malarial fever also. lu this case the 
greatest care will be necessary, and difficulty will be ex- 
perienced in making the dift'erentiation. 

Hemoglohinuric Fever. This gravest form of malaria 
resembles yellow fever somewhat in its onset and symp- 
toms — jaundice and albuminuria — but is characteristi- 
cally different in that you have evidence of the destruc- 
tive influences in the reduced number of red blood cor- 
puscles and low hemoglobin precentage in malaria and 
abscence of hemoglobin in the urine, of uncomplicated 
yellow fever. 

Dengue. It is not difflcult to differentiate be- 
tween marked types of yellow fever and dengue 
after the first two or three days. The principal 
points of difference are the almost universal pres- 
ence of an eruption in dengue and the absence 
of an eruption in yellow fever; the presence of jaun- 
dice in yellow and the almost universal absence of jaun- 
dice in dengue. Albuminuria is almost universally absent 
in dengue. It is possible for dengue and ^^ellow fever to 
exist by side, but in that event it would be necessary to 
carefully and closely observe a good number of cases be- 
fore a positive differentiation could be made. It is not 
probable that a large number of cases of dengue and mild 
yellow fever could be observed without some of these cases 
showing the characteristic lesions of the particular dis- 
ease more pronouncedly than the other, thereby relieving 
the doubt. 

La Grippe and acute lobar-pneumonia, particularly of 
apex, may possibly be counfounded with yellow fever, but 
a careful study of the case will reveal catarrhal symptoms, 
and the absence of bile-stained casts and debris in the 
urine, and ought not to be confounded with yellow fever. 
In yellow fever, the lungs are normal. 

Typhoid Fever in the early stages may possibly be taken 
for yellow fever, but the history of the case and the finding 



1162 AUGUSTIn's HISTORY OF YELLOW FEVER. 

of the Eberth bacillus, the Widal reaction, and the co- 
relation of pulse to temperature will help to clear up the 
diagnosis. Yellow fever may engraft itself upon any dis- 
ease, and I have held post-mortems in Cuba, showing the 
characteristic lesions of yellow fever and of typhoid fever, 
in cases in which malarial plasmodia were found in the 
blood during life. 

Acute Yelloiv Ati^opliy of the Liver is a very rare dis- 
ease, accompanied with a rapid reduction of the size of 
the liver, whereas in yellow f^ever the size of the liver is 
normal or is slightly enlarged. 

WeiVs Disease simulates yellow fever closely, the symp- 
toms being fever, jaundice, diarrhea and nephritis. The 
marked enlargement of the spleen and diarrhea will tend 
to differentiate this disease. The spleen in yellow fever is 
not enlarged or tender. 

Catarrhal Jaundice. In this disease we have little or 
no fever and none of the evidences of pain and violent 
acute toxemia found in yellow fever. 

It may at times become exceedingly difficult to differen- 
tiate between a case of gastroduodinitis in a chronic alco^ 
holic suffering from exacerbation of his chronic nephritis. 
Careful investigation of the history of a case of this sort 
and examination of the stools will throw light on the 
case. ; 

Acute Peritonitis associated with black vomit, may be 
mistaken for yellow fever, but here again the absence of 
bile-staining of the urinary debris will eliminate yellow 
fever.* 

General Summanj. ' 

No reasonable person will, of course, discredit the value 
of clinical experience as an aid in diagnosis, and when 
the clinically experienced practitioner avails himself of 
the clinical laboratory aids, there is small likelihood of 
error. 



* Goldberger, Bulletin No. 16, U. S. P. H. & M. H. Service. 



DIAGNOSIS JONES. 1163 

For the purpose of aiding those who may never have 
seen a case of yellov^ fever before, the following symptoms 
in the light of our present knowledge justify a diagnosis 
of yellow fever, after all other-Mseases have heem consid^ 
ered and excluded, where poissible, bearing in mind, how- 
ever, that in a small percentage of cases, yellow fever may 
be associated with any chronic disease, and some of the 
acute, as malaria and typhoid : 

1. A continuous fever of one paroxysm lasting more 
than twenty-four hours, with sudden onset, associated 
with violent pain in head, back or epigastrium, or any one 
of these localities — anorexia, nausea and vomiting. 

2. Pulse rapid at onset, but steadily becoming slower 
in many instances, while the temperature continues to 
lise; even, if rising and falling with temperature syn- 
chronously, being from 15 to 30 beats less than the usual 
ratio between pulse and temperature found to exist in 
most other diseases, often becoming very slow, 60 or be- 
low, soft and at times intermittent, and very irregular. 

3. Low blood pressure, 10 to 65 m.m. of mercury below 
normal. 

4. High blood count 4,000,000 and over, with other ele- 
ments in proportion, showing a concentrated blood. 

5. High percentage of homoglobin in the blood, often 
100 per cent, and over. 

6. Venous congestion, followed by stasis and jaundice 
in from one tO' several days, tending to bruise easily, and 
to hemorrhages of* gums, bowels, etc., but never of kid- 
neys or bladder, sometimes, of urethra. 

7. Albuminous urine, containing bile-stained casts and 
debris from the urinary tract; and often bile, and bile 
pigments. 



PEOGNOSIS OF YELLOW FEYEK. 

BY CHARLES CHASSAIGNAC^ M. D. 

Bean Neio Orleans Polyclinic; Editor Neio Orleans 
^^Medical and Surgical Journal/^ etc. 

The prognosis of yellow fever may be studied both 
from the general standpoint and that of the individual 
patient. 

To-day the relative virulence of an outbreak or epidemic 
can be estimated fairly well in advance. Such estimate 
should be based on three factors especially : 1° The data 
of the inception or the introduction of the disease in a 
given locality; 2° the interval elapsing before the exist- 
ence of yellow fever is discovered or acknowledged; 3" 
the degree of ability or desire on the part of the com- 
munity in which the disease prevails to carry out the 
proper sanitary measures. 

1° The earlier in the season the first case occurs the 
more, everything else equal, is there likelihood of an epi- 
demic and of the prevalence of a severe type of the dis- 
ease. Statistics show that in the past all the bad epidemics 
occurring in the City of New Orleans began early, notably 
that of 1853, the worst in its history; that year the first 
case was reported as early as May. All the other great 
epidemics started in either May, June or July. On the 
other hand, outbreaks beginning as late as August or 
September have invariably been of a comparatively mild 
type. 

2° The longer the period between the outset of the 
disease in a given place and the discovery of its exist- 
ence, the greater the severity both as to the extent of its 
prevalence and its virulence. 

3° When the authorities of an infected locality recog- 
nize the importance of intelligent sanitary work, where 
the inhabitants co-operate earnestly with them, and if 
sufftcient means are available to institute promptly all 
measures necessary for the protection of the sick against 
the bites of stegomyia mosquitoes, the destruction of in- 



PROGNOSIS CHASSAIGNAC, 1165 

fected mosquitoes, and finally the annihilation of all 
mosquitoes of the dangerous kind, either there is little 
danger of an epidemic if the early cases have neither been 
overlooked nor concealed, or at the worst the epidemic 
will be of a comparatively mild type and of short 
duration. 

It is unnecessary to go into details concerning the points 
outlined above in reference to prognosis in general, as 
they are readily supplied and explained by the mosquito 
doctrine of yellow fever which is adequately treated in 
other sections of this work. 

The prognosis in individual cases is not so easily made 
because numerous conditions and circumstances must be 
taken into account and carefully weighed before anj'thing 
like a safe estimate can be made of the patient's chances 
of recovery. 

There is no doubt that the average case of yellow fever 
in an individual blessed with healthy organs is far from 
being the terrible thing that it is usually pictured. That 
it is a disease, nevertheless, which at times puts the in- 
effaceable stamp of death on its victims at the outset can 
not be denied. At the present time, the knowledge we 
possess concerning the propagation of j^ellow fever and 
its practical application to a modification of the type of 
the disease, justifies the prediction that the latter will 
become less and less to be feared. 

Apart from the general tendency of yellow fever in any 
given outbreak, as already considered, the points chiefly 
to be taken into account in weighing the chances of any 
particular patient are as follows : 1" age ; 2° condition 
of the vital organs; 3° habits; 4° probable relative 
amount of poison introduced into the system; 5° sur- 
roundings of patient; 6° race; 7° treatment. 

We shall review these points seriatim^ leaving for sub- 
sequent consideration the diagnostic significance of some 
of the important symptoms of the disease. 

Age. The younger the patient, the better his chance 
of recovery. In infants and small children the disease is 
so mild as to have led to the belief that natives of New 
Orleans and other points formerly subject to frequent 



1166 augustin's history of yellow fever. 

outbreaks of yellow fever were immune to the disease. 
Natives usually had during childhood an attack so mild 
as to be unrecognized yet sufficient to produce immunity. 
The risk increases as the age advances, except in females 
at about the age of puberty, in whom the mortality ap- 
pears to be higher than in those a little older. 

Condition of the Vital Organs. When the organs are 
sound the patient, of course, has a better chance; especi- 
ally is this true as far as the kidneys, the liver and the 
heart are concerned, in the order named. The nearer 
normal is the individual, the less likelihood is there that 
some important organ will succumb either from toxemia 
or secondary septicemia, for the better can elimination 
progress and the more pronounced the resistance of the 
organism as a whole. 

Habits. The patient's former habits should be taken 
into account in attempting to prognosticate the outcome 
of an attack of yellow fever. The alcoholic, those guilty 
of other excesses, the overworked — all make poor subjects 
and are apt to offer less resistance to the inroads of the 
disease, one of the organs bearing the brunt of the attack 
is much more apt to be weakened already. Temperate, 
steady, sanely and not too strenuously occupied individ- 
uals stand the disease better and, other things reasonably 
favorable, are very likely to recover. 

Amount of Poison. There is no doubt in the writer's 
mind that the comparative amount of poison injected into 
the system of the victim by infected mosquitoes, plays 
an important part in determining the virulency of a 
given attack, as well as does the rapidity with which that 
poison is introduced. If and when that degree of infec- 
tion may be ascertained a prognostic element of value 
will have been secured. An individual who, through 
ignorance of danger or through apathy, recklessness, or 
the necessity of circumstances, receives numerous bites 
within a short period stands a good chance of having a 
dangerous attack and perhaps succumbing if some other 
unfavorable feature is present in his case. On the other 
hand, one who, despite his understanding of the conse- 
t[uences and all care possible, still gets a bite or two 



PROGNOSIS CHASSAIGNAC. 1 1 67 

will probably have only a mild attack. The French ob- 
servers in Brazil have stated as one of the conclusions of 
their experiments that a single bite from an infected mos- 
quito never proved fatal. 

Surroundings. It stands to reason that well nourished 
people in comfortable and sanitary habitations, invalided 
in cheerful and well ventilated apartments do better than 
those who live in dark, dingy, close and unsanitary tene- 
ments. The mortality is always higher among the alien 
poor who live more or less crowded together in unsan- 
itary tenements. 

Race. The prognosis is better by far among the blacks 
and colored than among the whites, even when the former 
are otherwise in less favorable condition or surroundings. 
Whether this is because the darkies merely possess a 
higher degree of resistance to this particular poison, or 
because their skin being tougher and their odor more 
repellent to the mosquito, they are less frequently bitten, 
we are not prepared to say. The fact remains that the 
majority have the disease in a mild form and that the 
mortality among them is almost nil, so much so that they, 
like white children, had been supposed to be immune until 
comparatively recently. 

Treatment. The medical treatment and the nursing^ 
the patient receives figure largely in the result and a 
knowledge of what it is to be in any given case may be 
of material assistance in our prognostications. The suf- 
ferer who is fortunate enough to have an intelligent and 
experienced medical attendant of the ^'let well enough 
alone" type, and to be nursed by a quiet, careful nurse 
of judgment stands the best chance of getting well. The 
one who is treated by an inexperienced physician who is 
guided by the advice set down in the book of some noted 
therapeutic authority who has never seen a case of yellow 
fever is very apt to die. 

By weighing the elements tending for or against the 
patient according to the points considered under the 
seven heads above, one possessed of a fair amount of judg- 
ment can make a pretty fair prediction as to the outcome 



1168 augustin's history of yellow fever. 

of any particular case, if at the same time, proper con- 
sideration is given to tlie prevalent type of the disease. 
- In addition to what has just been said, it is proper to 
call attention to the relative prognostic value of some of 
the symptoms of the disease. These are mainly : the tem- 
perature, icterus, the urine, and hemorrhage, including 
black vomit. 

Temperature. If at the outset the temperature is only 
of moderate intensity, ranging not above 103 1/2° to 
101° in adults, and especially if defervescence is prompt 
and raj)id, the prognosis is good as far as this point alone 
can be a guide. With the same degree of elevation in the 
beginning, if the temperature remains stationary or, par- 
ticularly, if it rises at all the next day, the prognosis is 
grave. Should the fever reach or surpass the 105 degree 
point during the first twenty-fotir hours the prognosis is 
bad; the patient has a very slim chance of recovery and 
that only if all other indications are favorable. 

Icterus. The more intense the ictertis and the earlier 
it shows itself the graver the prognosis. When there is 
a very marked jaundice by the third day or earlier, it is 
an evidence of profound toxemia and there is good ground 
for serious anxiety as to the outcome of the case. 

Urine. The condition of the urine furnishes valuable 
indications as to the prosjoect of recovery. Its quantity 
is of greater comparative significance even than its con- 
dition. As long as the patient can urinate abundantly 
the prospects are good, even if the percentage of albumen 
is fairly large. In fact, I have seen patients recover whose 
nrine was highly albuminotts and loaded with casts bat 
continued copious ; the laboratory prognosis differed from 
the clinical and the clinical proved correct. 

Whenever the urinary secretion becomes scanty, dan- 
ger must be apprehended and suppression of urine means 
death, the exception being that which proves the rule. 
The patient is overwhelmed by toxemia, uremia and some- 
times septicemia combined, coma or convulsions super- 
vene and the patient's sufferings are ended. 

Even retention of urine is a bad omen as it is frequently 
a forerunner of anuria. This is probably because the 



PROGNOSIS CHASSAIGNAC. 1169 

impairment of fiiDctiou leads to a very slow and gradual 
filling of the bladder, the call for urination being slight 
in consequence and not becoming insistent before the 
secretion ceases ; when the catheter is introduced the first 
time a fair amount of urine may be withdrawn while 
at its second introduction, seyeral hours subsequently, 
scarcely any may be found — there is no longer retention 
but suppression. 

Nothwithstanding what has just been written about the 
greater importance of the abundance of urine, it must not 
be concluded that the urinary findings are of no prognostic 
value. A very large proportion of albumin is of serious 
import, more so if present early and especially as early as 
the second day of the disease. The more casts are found, 
the more danger of serious damage to the kidneys. When 
the urine is highly albuminous, loaded with casts, and at 
the same time scant}^, the prognosis is most gloomj^ 

Hemorrhage. From the injection of the conjunctiva, 
the flushing of the face, ej)istaxis and, later, other hemor- 
rhages, there is evidence throughout of the decided effect 
of the disease on the circulation. The degree of this 
effect and the time at which its phenomena apiDcar are of 
prognostic import. 

Epistaxis and moderate menorrhagia or metrorrhagia, 
at the outset, produce relief often and are not a bad sign, 
except during pregnancy. It must be remembered, how- 
ever, that the bleeding at the nose may give rise to un- 
necessary alarm when the blood is swallowed and then is 
vomited after being in the stomach for a while. This is 
taken by the inexperienced for black vomit, but may be 
differentiated chiefly by the fact that it can be ascertainea 
there has been nose bleeding and that this occurrence 
comes early, generally some time on the second da^^, a 
period too early for the true and much dreaded black 
vomit. I 

Bleeding from the gums is a grave sympto/m and the 
earlier it appears the more significance must be attached 
to it. Coming as early as the third or fourth day, it in- 
dicates a very serious condition. Danger need be 



1170 augustin's history of yellow fkvesu 

apprehended less if the sponginess and bleeding of the 
gums is present only after the fourth day. 

Hemorrhage from the intestines is always a dangerous 
indication and death is very apt to follow when there 
occur bloody stools of a gangrenous odor. 

Like other hemorrhagic symptoms, bleeding from the 
stomach, which produces what is usually termed black 
vomit, is of the gravest import when it occurs as early 
as the third day ; on the fourth day it is still a very bad 
sign and means almost sure death if the gums also are' 
bleeding ; if only on the fifth or sixth day and, particularly 
if at that time the gums are still firm and do not bleed, 
the prognosis is not so gloomy. The quantity of vomit 
also counts, the more of it and the more often it happens, 
the worse the indication. 

It has been outlined, then, that by the aid of some 
definite propositions it is possible to proiDhesy about the 
type or degree of virulence of the disease which is to be 
characteristic of a given outbreak. It has been shown 
next that the past history and the actual condition of 
the patient can furnish valuable prognostic data. Finally, 
we have determined that a proper study of some of the 
important symptoms will yield important information as 
to the outcome of an attack of yellow fever. It must 
be added that, after all is said, the experience and judg- 
ment of the observer must remain im^Dortant factors m 
determining the accuracy of his prognosis. Neither must 
it be forgotten that '^yellow fever is a disease of surx)rises." 
Some patients have died whose recovery had been con- 
fidently expected, while we have known others who re- 
covered after their death certificates had actually been 
written out. 

As Touatre has said, "a patient must never be given 
up!" 



1171 
THE TEEATMENT OF YELLOW FEVEK. 

By Lucien F. Salomon^ M. D. 
Secretary Lmiisiana State Board of Healthy 1886-1893. 

In preparing this article npon the treatment of yellow 
fever, it has been my effort to avoid technical terms and 
phrases, and so ex]3ress myself as to make the subject 
plain to the lay mind so that in the event of a physician 
not being obtainable any person of intelligence will be 
able to manage a case, until the patient can be seen by 
one. On the other hand, the treatment here given is 
recommended to practitioners of medicine as the result of 
a very large and successful experience in yellow iever. 

Many years ago, in the early days of my practice, I 
found that potassium nitrate was almost as ef&cient, if 
not as sure an antidote to the malarial poison, as quinine ; 
and long before the microbiological investigations which 
have since been made, demlonstrated that Yellow Fever 
was not caused by a microbe, the peculiar hemorrhagic 
tendency of the disease, resembling so closeh^ the hemor- 
rhagic form of malarial fever, led me to use potassium 
nitrate in the treatment of Yellow Fever. As a result, I 
am prepared to state, and also confidently assert, that in 
a majority of instances, a case, if seen within the first 
twenty-four hours and treated according to the method 
which I shall give, is converted into a simple pyrexia, 
with rapidly declining temperature, terminating at the 
end of the third clay, and not followed by the secondary 
rise so often seen. 

Of course, the mere administration of drugs does not 
constitute the entire treatment of any disease, but, having 
in the first instance administered what I consider an 
antidote to the poison, then it becomes our duty to so 
manage the case as to conduct our patient to the safe 
harbor of recovery. 

With these preliminary remarks, I shall now proceed 
to describe how to treat Yellow Fever. The first step 



1172 AUGUSTIN S HISTORY OF YELLOW FEVER. 

necessary is the administration of a large saline purga- 
tive, preferably sodium sulphate. This will thoroughly 
cleanse the entire intestinal tract. It is not necessary 
to give calomel or any other purgative, because the sodium 
sulphate, in addition to its flushing power, also acts as 
a cholagogue. It will often be found that when the 
patient is seized with the attack there is undigested food 
in the stomach. If such should occur within a short time 
after eating, he will vomit and empty the stomach of the 
food. If the seizure should come on three or four hours 
after a meal, and there is still some undigested food in 
the stomach, there will be nausea. In such cases it is 
well to give minute doses of calomel, for the purposes of 
quieting the stomach, so that the sodium sulphate will 
not be rejected. For this purpose, the following combi- 
nation is best adapted to the purpose: A powder con- 
sisting of one-quarter grain of calomel with one grain of 
ingiuvin. This to be repeated every twenty minutes until 
four are taken, and then followed, in one-half an hour, 
with one-half or one ounce of sodium sulphate dissolved 
in a glassful of water. It will be found very frequently 
that the intense headache accompanying the onset of the 
attack will be relieved after the administration of the 
saline. If not, relief can be obtained by the old-time hot 
foot-bath, which, by the way, I never use except for the 
relief of said condition. One hour after the administra- 
tion of the purgative, and without necessarily waiting for 
its action, begin the administration of the following 
prescription : 

Potassi nitratis 1 dram 

Liq. ammonite acetatis 3>^ ounces 

Syr. aurant flor >^ ounce 

The adult dose of this mixture is one-half ounce, re- 
73eated every two hours during the continuance of the 
fever. The liquor ammonite acetatis is administered in 
conjunction with the potasium salt for its action on the 
skin, as it causes free diaphoresis, thus fa Adoring elimina- 
tion. The potassium nitrate, in addition to what I con- 



TREATMENT SALOMON. 1173 

sider its specific effect as an anti-toxin, also plays a \erj 
i]nportant part by acting as a prophylactic diurectic. 

It will be found, as a rule, within a few hours after 
beginning the administration of the above mixture, that 
the temperature, no matter how high at the onset, will 
begin to decline, and will decline progressively until the 
end of the third day, when convalescence will begin. 

In addition to the remedies above mentioned, there are 
several cardinal points in the management of a case of 
Yellow Fever which should be borne in mind. The first 
is absolute rest in the recumbent posture, not allowing 
the patient even to raise his head for any purpose what- 
ever. Second — Absolute abstinence from food of any 
description, liquid or otherwise, until the complete subsi- 
dence of the fever. Third — Careful attention to the 
thorough emptying and cleansing of the lower bowel by 
large enemata administered at least once dailj^, using for 
this purj)ose at least two quarts of normal salt solution. 
Water and ice should be allowed ad libitum, preferably 
carbonated water, such as Apollinaris, carbonated lithia 
water or seltzer water. If the patient is averse to the 
carbonated water, plain vicliy may be given. 

After the fever has subsided, the temperature often 
becomes sub-normal. The patient is now in what is called 
the algid stage. Very often the extremeties Avill be cold ; 
sometimes the entire body is cold and clammy to the 
touch. For this condition there is nothing better to re- 
store the patient to a normal condition than a small glass 
of ale administered every two hours, in conjunction with 
nux vomica and caffeine. I usually administer one-eighth 
of a grain of extract of nux vomica with one or two grains 
of caffeine citrate every two or three hours, as the case 
may require. 

In beginning to feed the patient, which may be done on 
the fourth or fifth day of the disease, great care is neces- 
sary. For the first day, give two ounces of weak chicken 
broth, to be repeated at intervals, and nothing else. The 
next best step in the feeding of the patient is the adminis- 
tration of butter milk. Butter milk is easilv retained 



1174 augustin's history of yellow fever. 

and digested, besides being grateful to the patient. From 
this, go to sweet milk, beef or chicken soup thickened with 
rice or barley, and after a few days, gTadually to the nor- 
mal diet. 

I have outlined above the treatment of a simple, un- 
complicated case of Yellow Fever, but one will often be 
confronted with cases that will tax one's ability and in- 
genuity to the utmost. 

We will begin with the most ordinary complication, the 
one most often met with — that is nausea. This can gen- 
erally be relieved with milk of magnesia. This failing, 
there may be added to it one or two minims of creosote. 

You will occasionally find that, in spite of above treat- 
ment, the tem^Derature continues high. In efforts to re- 
duce high temperature beware of the use of so-called anti- 
pyretics; such drugs as phenacetin and its congeners are 
positively vicious in their effects. The disease itself is 
sufficiently depressing without adding to the depression. 
I believe firmly that many a life has been lost in Yellow 
Fever by the administration of these preparations. Water 
externally, either by sponging or the application of the 
wet towel, will almost invariably reduce the temperature. 
Never use ice water. My method is to use tepid water 
always. Frequent sponging will generally reduce the 
temperature. If not, the application of the wet towel will 
accomplish the desired result, particularly if it is carried 
out the following plan which I have of tenr adopted : iThe 
patient is covered from chin to feet with a large bath 
towel saturated with tepid water, and then the nurse or 
attendant is made to fan the patient, thus creating a 
current of air and causing rapid evaporation, and equally 
rapid reduction of temi^erature. I have many times in 
this manner brought a temperature of 104^ or 105 below 
103 in half an hour. 

The next step to be considered is black vomit. I pause 
here to state that in 1878, at the outbreak of Yellow Fever 
in New Orleans, I gave the r.esult of my experience (in a 
discussion before the New Orleans Medical and Surgical 
Association) with ergot in controlling black vomit. The 



TREATMENT SALOMON. 1175 

suggestions then thrown out based upon past experience, 
were adopted by a number of physicians during that epi- 
demic, and Dr. S. S. Herrick published the result of his 
experience in the use of ergot in Yellow Fever. I have 
frequently, and almost invariably, controlled black vomit 
with hypodermics of ergot, administration by the stomach 
of creosote, either with chalk mixture or milk of mag- 
nesia, and the application of the ice bag to the epigastrium. 

Now we come to the most dangerous condition that msiy 
arise in Yellow Fever, and one of the most difficult to 
overcome — that is the suppression of urine. As a rule, 
under the treatment above suggested, this condition is very 
rare, owing, as stated in the beginning, to the prophy- 
lactic diuretic effect of the potassium nitrate. Should, 
however, the urine become scanty, or altogether cease, the 
remedy is ergot. Ergot administered hypodermatically 
will almost always relieve this condition, especially if 
combined with the administration of caffeine. 

Of course, the above briefly outlined treatment of Yellow 
Fever, it is not claimed will cure all cases. That is some- 
thing beyond human ability, but from an experience of 
over two hundred and thirty cases without a death, I am 
led to believe that by the method given and the proper 
care of each individual case the mortality will be exceed- 
ingly small, and I put it forth in the sincere hope that it 
will be to some extent helpful in saving human life. 



1176 

THE LOUISIANA SYSTEM OF HYGIENIC 
EDUCATION. i 

By Fred J. Mayer, M. D. 

Secretary Louisiana State Sanitary Association. 

"Every mind was made for growth, for knowledge, and in its 
nature is sinned against, when it is doomed to ignorance."— nChanning. 

"A knowledge of the laws of life is more important than any other 
knowledge whatever. * * * ^ knowledge which subserves direct 
selfpreservation, by preventing loss of health, is of primary im- 
portance." — Spencer. 

At the beginning of the great yellow fever epidemic of 
1878, a medical student, from one of the interior towns of 
Louisiana, who had been studying the symptomology of 
the disease in New Orleans, fell sick, and profoundly im- 
pressed with the non- contagiousness of the disease, re- 
turned to his home and was received at point of pike and 
gun, and for a period of nearly forty days subjected to a 
brutal and inhuman quarantine. After recovery from 
the attack, supposed to be yellow fever, for which the 
quarantine was imposed, and from the first wild outburst 
of passion against those in authority responsible for the 
inhuman restrictions, leveled against the victim, his 
mother an immiune who nursed him and his brother who 
met him on his arrival, his thoughts naturally reverted 
to the cause of the wild, panicky and insensate fears that 
would drive a community to treat the victims of a con- 
tagious or infectious disease as though they were crim- 
inals, nay worse, for even with barbaric tribes the con- 
demned criminal is afforded food and shelter until such 
time when he must pay the penalty for his infraction of 
the tribal law, while in civilized . communities the poor un- 
fortunate victim of a disease, for which he is in no wise 
responsible, is not only frequently denied these, but at 
the point of a shot gun is prohibited from securing the 
necessities of life, which he may have the ability and 
desire to pay for. 



LOUISIANA SYSTEM OF HYGIENIC EDUCATION MAYER. 1177 

This train of thought could lead to but one conclusion : 
That ignorance of the cause of the disease, its manner 
o5 propagation and its prevention, was at the bottom of 
the trouble; another thought occurred: that this magni- 
ficent State, with its Avonderful resources of field, farm 
and mine, reticulated with 4000 miles of navigable water- 
ways, with a balmv climate and a soil rioting in profusion 
of raw materials and fuel to convert them into those pro- 
ducts upon which empires are built, with a hospitable 
people in whom the American instinct of fair pla^^ Avas 
strong, whose qualities of physical courage had been tested 
in the crticible of Civil War and Reconstruction, shotild 
be absohitely inhibited in its growth and evolutionary 
development by the fear of an ultra-microscopic germ, 
periodically sown by the bronzed harvester of Death. 

The strange immunity of those communities in the in- 
fected areas, off the lines of travel, or which had insti- 
tuted rigid quarantine, plainly pointed to some vehicle 
of transmission of the yellow fever germ at that time 
supposed to be fomites, and suggested that the only sen- 
sible way to deal with the problem was to institute a 
sane and scientific quarantine, with the minimum of hard- 
ship inflicted on the commercial interests, and that until 
the masses of the people were sufficiently instructed to 
apply the fundamental principles of hygiene to the sup- 
pression of disease, this panicky feeling wotild continue 
and periodical exhibitions of shot gun quarantine bar- 
barities would recur — the remedy was apparent : Educate 
the masses — not only the children in the schools, but the 
grown folks — many of whom had successfully crossed the 
pons asinorum', and could most learnedly discourse with 
the muses, but who were profoundly ignorant of the rudi- 
mentary rules of liije. 

Of a verity the paraphrased caustic lines from Hudibras 
fitly apply: 

"Full many a youth returns from school 
A Latin, Greek and Hebrew Fool. 
Full many a man returns from college 
With a head choke full of useless knowledge 
In sanitary science still a block 
Tho' deeply skilled in hie haec hoc." 



1178 ArorsTiN's history of yellow fever. 

In 1SS2, Koch having pointed out : "the constant pres- 
ence in tuberculous tissue or matter of a well defined 
micro-organism, caj)able of reproducing tuberculosis when 
isolated and injected into healthy animals,'' it was evi- 
dent: that the theory of heredity was no longer tenable, 
and that this dreadful disease, which since the dawn of 
history, ^^arose and o'ershadowed the earth with its name," 
could only be stayed in its triumphant march by a stiidv 
of its cause, nature and prevention ; and that this knowl- 
edge should not be confined to the family physician, but 
should be made common i)roi)erty, so that the simplest 
mind could realize the dangers of tuberculous sputum. 
of meat and milk from dairy herds that had net been 
subjected to the tuberculin test, and the role that the 
common house fly and bed bug plays in the transmission 
of the bacillus tuberculosis. 

The extreme conservatism of the medical profession, 
which seemed to regard as unethical any disctission of 
medical subjects with the laity, stood as a bar to any 
acqu.iesence in or ready acceptance of the principle o:^ 
public instruction in the catise. nattire and prevention of 
commuicable diseases, the writer, while never accepting 
the correctness of this ultra- conservatism, holding it a 
colossal mistake to permit lay writers to trench tipon 
ground, which should have been traversed by medical men 
alone, yet not wishing to appear unethical, pushed the 
plea for public instrtiction before the old Attakapas Medi- 
cal Society, before the Orleans Parish Medical and Stirgi- 
cal Society, and before the Louisiana State 3Iedical Socie- 
ty, tmtil it won their approval as evidenced l>y the formal 
resolutions adopted. The State A.orictiltural Association 
endorsed this plan of hygienic education, twice by formal 
resolution : the State Pharmacetitical and Dental Associa- 
tions and the Mobile Quarantine Convention endorsed the 
l^rinciple unanimously. 

Armed with this medical endorsement, the fight for the 
principle was carried before the American Ptiblic Health 
Association at the Mexico meeting in 1893. Later, at the 
annual convention of the same body in ]S'ew Orleans, and 
at the 1906 meeting in the Citv of Mexico; under the 



LOUISIANA SYSTEM OF HYGIENIC EDUCATION MAYER. 1179 

rules of this Association, all resolutions are referred to 
the executive committee which failed to rei^ort back the 
resolutions, there is no question that in an open field, on 
the floor of the House, it would have Avon recognition, 
since the principle underlies the objects and purposes of 
the organization, as set forth in Article 2 of the Consti- 
tution, viz. : ^'tlie advancement of sanitary science and the 
promotion of organizations, and the measures for the prac- 
tical application of public hygiene," the Louisiana system 
simply goes a step further in carrying hygienic instruc- 
tion to the masses of the people in the homes and by their 
firesides, by Cliatauquan methods. 

At the New Orleans meeting of the American Medical 
Association, a resolution offered by Dr. Sanders, State 
Health Officer of Alabama, endorsing the principle of this 
system was unanimously adopted hj the section on 
hygiene, referred under the rules to the general Committee 
en Resolutions and never reported back, so evidently the 
medical mind is not yet fully converted to the idea that 
the highest duty of the physician is prevention and not 
cure.* 

*Since this was written, the American Medical Association has 
had Dr. McCormack visiting the entire country, advocating 
Public Education in Hygiene, and at the Chicago Meeting 
of the Association, June 2-5, 1908, Dr.. Burrell of Boston, its 
President, devoted his Presidential address to the "New 
Duty of the Medical Profession, the Education of the 
Public in Scientific Medicine. Vide Journal A. M. A., Vol. 
No. 23, p. 1873. At the same meeting Dr. Harrington, of 
Boston, in his address on "States Rights and the National 
Health," among other things said: 

"In arousing the public to a proper appreciation of the 
importance of public hygiene, we have far more to fear from 
professional than from lay ignorance." * * * 

The creation of educated public interest in the National 
health is a duty which happily does not belong to any one 
class or calling, each in his way can do his part by precept 
and example, of great value as shown in the agitation for 
the law relative to foods, and here, there and everywhere 
for the establishment of Sanatoria, for ordinances against 
the spitting habit, are popular lectures, magazine articles, 
and the sympathy of the press. 



1180 augustin's history of yellow feyer. 

In the winter of 1882, with the niemorT of the yellow 
fever epidemic of 1878-1879, still fresh, and the niortnarj 
statistics of tuberculosis bristling with its annual holo- 
caust, a scheme of Public Instruction in HTgiene was 
evolved, which should start in at the Kindergarten, con- 
tinue through the primary and academic grades, to the 
college and university, and university extension ^^ith 
some great Central Institute of Hygiene as a focal point 
from whose portals could be issued a journal, bulletins 
and leaflets in all the tongues spoken in the State, and 
a corps of trained Lecturers organized for the instruction 
of the masses. 

The scheme was considered a Utopian dream by most 
medical men, who held that the Medical Colleges nad 
Chairs of Hygiene, and that the rudiments of that science 
could be taught in the public school, unmindful of the fact 
that even in Medical Colleges Hygiene was usually an un- 
important adjunct to the Chair of Materia-Medica, and 
that the teachers in the public schools themselves needed 
instruction, and so the plan for want cf means to carry it 
into execution failed to materialize. 

"Two years ago there was inaugurated at the Harvard 
Medical School a series of free public lectures, given on 
Saturday evenings and Sundaj' afternoons for four months, 
mainly on Preventive Medicine. The first series was a most 
gratifying success; the second so largely attended that at 
times more people were turned away than succeeded in 
securing places. The chief result is a widespread interest 
in public hygiene, and marked strengthening of the cordial 
relations which ought to exist everywhere between the pro- 
fession and public." (Journal A. M. A., Vol. No. 24, p. 1959.) 

On July 18, 1908, the editor of the Journal A. M. A., in an 
article entitled "Relation of Education to Preventive 
Medicine," in commenting on Dr. Ditman's monograph on 
"Education and its Economic Value in the Field of Preven- 
tive Medicine," says: "Eff active measures for removing the 
causes of disease can be carried out onh* with the support 
of an enlightened public opinion, and this must be formed 
by education." (Vide Journal A. M. A., Vol. 2, No. 3, p. 227). 

In volume 51, No. 4, p. 323, in commenting on "The Louisi- 
ana System of Hj'gienic Education," the editor says: "On 



LOUISIANA SYSTEM OF HYGIENIC EDUOATION MAYER. 1181 

One of the distinctive features of the system, and the 
one from which it was expected to get the best results, 
was a series of popular lectures illustrated with lantern 
slides, breaking the continuity ofj tlie strain on the lay 
mind by appropriate musical and recitative numbers, be- 
tween each lecture and discussion. In 1885, as an exper- 
iment to test the correctness of the theory, this idea was 
carried into execution and the most gruesome subject 
purposely selected for a popular lecture, viz. : ^^The Sani- 
tary disposition of the dead." The kindly manner in 
which this dismal topic was received, confirmed the cor- 
rectness of the theory ; the only thing that remained to be 
proven, was : whether public interest could be kept up for 
any length of time, and the opportunity for proving this 
did not present itself until 1897, when the first popular 
Institute of Hygiene ever held was convened in the town 
of Opelousas, in this State. The session opened in the 
morning, lasted all day and all night. At mid-night an 
adjournment was taken to enable the ladies to retire, and 

the intelligent co-cperation of the public the ultimate suc- 
cess of Sanitary legislation must largely depend. A useful 
auxiliary in this direction already exists in what has been 
called 'The Louisiana System of Hygienic Education,' the 
essential feature of this movement, according to Dr. F. J. 
Mayer (Rept. of Spec. Med. Insp. La. State Board of Health, 
1908), consits in the holding of Institutes of Hygiene before 
Colleges, High Schools and Special Institutes. By this 
means not only is a considerable portion of the populace 
instructed in the nature and prophylaxis of transmissible 
diseases, but the movement is further extended by the 'per- 
fect correlation of the clergy of all denominations, educa- 
tors, scientists and the press with the health service of the 
State in its educational efforts.' * * * 

"The further extension of this movement is much to be 
desired. It seems desirable, however, as Dr. Mayer suggests, 
that the educators should be independent oflEicials, not 
engaged also in field work; not only because there is work 
enough of that kind alone to engage their attention, but 
also because their teaching is apt to be looked on with 
suspicion by the ignorant if it emanates from one charged 
with executing the ordinances of the Board." (V. J. A. M. 
A., Vol. 2, No. 4, page 823). 



1182 

the Institute reassembled at 12 :30 P. M., when a lecture 
was deliyered for men only; it was 2 o'clock A. M. before 
the successful experiment adjourned sine die. Many of 
the leading Sanitarians of the State participated ; includ- 
ing Drs. Dalrymple, Metz, Dyer, Chassaignac, Formento, 
E. D. Martin and others. Those who have had experi- 
ence with agricultural and pedagogical institute work will 
recognize the success of holding the wrapt attention of an 
audience tor such a lengthy period. Water, Hygiene of 
the skin, Sexual Hygiene, Cremation, Anthrax (Charbon), 
Variola and Vaccination, Yellow Fever, Typhoid and Con- 
sumption were lectured on and discussed before a packed 
house. 

The practical benefits of this institute were felt the next 
day in an overhauling and cleaning of cisterns, the chief 
source of drinking water in the town. Some of these 
tanks had not been cleaned since the war, and contained 
two feet of black pultaceous mud reeking with organic 
filth. Attention was directed to the dangers of polluted 
milk supply, and people boiled milk who formerly had con- 
sumed it raw, although the cows supplying it drank from 
the town creeks polluted with sewage.** 

The next year another institute was held in Baton 
Bouge, through the exertions of Dr. Dalrymple, Professor 
of Comparative Anatomy in the L. S. U. & A. M. College, 
and recently elected President of the American Veterinary 
Medical Association. 

These two institutes, while demonstrating the feasibilty 
of the plan, made manifest the fact, that the expense was 

**T]ie unbroken continuity of interest manifested at this Institute 
was due to the fact: that under the guidance of an eminent 
musician the phj'siological effect of music on the nervous 
system was taken full advantage of in lessening the strain 
on the lay mind, which otherwise would have been unbear- 
able in a mixed audience. The use of music is an impor- 
tant adjunct of the Louisiana System of Hygienic Education, 
and applies with equal force to all institute work; like all 
nerve stimuli, it must be used with discriminatory judgment, 
hence the very best musicians should be consulted in ar- 
ranging the musical part of the program; it would never do 
to follow a discourse on death in its protean forms, with an 
aria, one might say mal-aria, the lugubrious strains of which 



LOUISIANA SYSYEM OP HYGIENIC EDUCATION MAYKR. 1183 

too heavy for the individual, and that it was the duty of 
the State to furnish this instruction. These institutes 
were held under the auspices of the ''Louisiana State Sani- 
tary Association." The purposes and objects of this cor- 
poration as set forth in Article II of its constitution 
adopted November 22nd, 1897, are declared to be : 

"The advancement of sanitary science, 

"First. By the organization of a central body with 
auxilary circles in every parish in the State and its ex- 
tension, until it embraces all the Southern, and particu- 
larly the Gulf and the South Atlantic States. 

Second. The founding of a school of Hygiene and Quar- 
antine on the Chatauquan plan of correspondence. Lec- 
tures and Summer Institutes. 

Third. The publication of a monthly Journal devoted 
to the objects of the Associations. 

Fourth. To secure through an educated public opinion 
the enactment of adequate health laws ; laws on vital stat- 
istics on food adulteration and water pollution, on meat; 
and dairy inspection, on vaccination and their enforce- 
ment; and the founding of hospitals for contagious 
diseases. 

Fifth. To systematically educate the people of the 
State to the necessity of substituting rational, scientific, 
uniform, maritime and inland quarantines during periods 
of epidemic danger or invasion for the barbarous shot- 
gun quarantines, which while crippling commerce, afford 
at best a doubtful and insecure protection. 

Sixth. The restriction and prevention of tuberculosis 
and the founding of sanitaria for its Hygienic-Dietetic 
treatment." 

following closely after the dreary dissertation might pile 
Pelion on Ossa; nor would it serve the purpose to follow 
the discourse with some excruciating rag-time that would 
rudely check the rising tide of sympathy and deflect its 
current into a channel of levity, the sympathetic interest 
and attention of the audience would be balked. Rostand 
elaborated the idea in "Cyrano de Bergerac," when the 
thoughts of the starving Cadets of Gascony were turned 
and raised to higher levels by music that appealed to loftier 
, ' instincts. « 



1184 AUGUSTIX'S HISTORY OF YELLOW FEVER. 

The charter provides for representation of all interests 
concerned i)articnlarlT to that mighty agent of reform, 
the Press and declares : "That its Advisor y Council shall 
consist of delegates from each Sanitary Circle in the 
State, from each Town Council and Police Jtiry of the 
State, from the Commercial Exchanges and Beards of 
Trade, from the Boards of Health, from the Medical, 
Pharmaceutical and Dental Societies, from the Colleges, 
from the Louisiana Chatauqtia and other edticational and 
scientific bodies, from the Press Association of the State, 
and the Press Club of Xew Orleans, and the Commercial 
Travelers' Association ; the basis of representation from 
each to be fixed by the Executive Committee.-' 

These two committees shall, in joint session, ''Serve as 
a nominating committee of ofiicers and committeemen, for 
the ensuing year and make stich recommendations to the 
Association as shall best secure the objects of its 
creation." 

The membership is composed of active, associate, hon- 
orary and non-resident corresponding members, the Exec- 
utive Committee determining for which class a proposed 
member shall belong; there is no initiation fee and the 
anntial dties are fixed at SI. 00, and the liabilities of mem- 
bers limited to the amount of their annual dues, and "this 
society may incorj)orate with similar or other sanitary 
associations in the other Southern States in such manner 
as its Executive Committee may determine. '- 

The Secretary is ex-officio State organizer. 

Copies of this Charter were sent to the Exchanges and 
Transportation Companies, but failed to attract atten- 
tion, although as per reference to Section 5, of the Char- 
ter, it will be seen they would have been the chief benefici- 
aries. The business mind had no patience with any 
system that required time for a proper evolutionary devel- 
opment; what it desired was a speedy estoppel to shot 
gun embargoes on commerce, and vainly imagined, as 
many of them still do, that all that was necessary was 
the exhibition of physical force on the part of the State 
or National government. 



LOUISIANA SYSTEM OF HYGIENIC EDUCATION MAYER. 1185 

Here it is wliere a great divergence of oi3inion exists, 
those who have more closely studied the question, recog- 
nize that the average American is imbued with the old 
Anglo-Saxon idea, that every man's house is his castle, 
and that he has an inherent and inalienable right to de- 
fend it from invasion, whether the invader comes in the 
form of a burglar or a foreign disease germ, and that, 
whether he has a legal right or not, he is going to take 
it; now when whole communities become obsessed with 
this view, and, in the furtherance of their belief in the 
right of self-preservation, commit excesses not warranted 
by science, it is apparent that the only permanent relief 
to be obtained is from a better enlightened public opinion. 
In the reign of Elizabeth, a gibbet was set up at every 
mile post, from Lands End to New Castle, in the hope af 
stopping smuggling, and failed, and our own well ap- 
pointed revenue service cannot wholly prevent infraction 
of the law; the whole army of the United States if im- 
pressed into service as a quarantine guard might for a 
time enforce the passage of trains through territory quar- 
antineed against infected areas, but it could not prevent 
the torch from being ai3plied to a railroad bridge, nor the 
raising of a rail by the mid-night x^rowler, and this would 
for a time put a stop to commerce. Nor conld all the 
powers of the United States force a commuity to carry 
on business relations with centers of infection if they 
felt indisposed so to do; so in the last analysis any sys- 
tem of inter or intra- State quarantine, whether under the 
control of the Federal or State authorities, to be effective 
must have an enlightened public opinion back of it so 
that its provisions may be enforced. For as Lincoln said : 
"With public sentiment nothing can fail, without public 
sentiment nothing can succeed, consequently he who 
moulds public sentiment goes deeper than he who enacts 
statutes, or ]3ronounces decisions, he makes statutes and 
decisions possible to be executed." 

In 1898, and for four years thereafter, through the 
courtesy of the State Department of Agriculture, it was 
made possible to carry on a series of Lectures on Hygiene 
of the Home and Farm, including Lectures on Consump- 



1186 augustin's history of yellow fever. 

tiou, Sin;all-pox, TTi3hoid FeTer, Anthrax^ Water and In- 
sects in their relation to public health, drainage, etc. 
At these lectures it was noticeable that the farmers took 
as much interest in Hygiene as they did in the agricul- 
tural discussions, their questions showing that they real- 
ized that ill-health in man and beast was the most serious 
economic leak on the farm. 

In 1900, a bill was drafted and presented to the Gen- 
eral Assembly by the late Ex- Speaker Henry, of Cameron, 
to create a Commissioner of Hygiene whose function 
would hare been x)urely educational and whose prmciiDal 
duty would hare been to lecture before the Agricultural 
and Pedagogical Institutes, the Colleges and High 
Schools, and before Si^ecial Institutes of Hygiene at the 
County Seat of every Parish. 

Under the political conditions existing at that time, 
it was considered a hopeless task to attempt to pass any 
measure opposed by the Chief Executive, for the appoint- 
ive power iDlaced in the Governor's hand, a sword with 
which he could slash right and left and whip recalcitrants 
into line with the flat side. Nevertheless, before this able 
body, with the Governor violently opj)Osed to its passage, 
the Hygiene Bill won recognition by a vote of 63 
to 27 in the Lower House, and 26 to 6 in the Senate, 
solely on the strength of its merit. The Governor 
vetoed the measure on the ground that the State was 
not able to stand the expense of -flOOO per annum 
asked for. Two years later the Bill was reintroduced 
by Hon. W. W. Yentress, a distinguished Sugar Planter 
of Iberville, passed the Lower House hj 63 to IT, 
with 18 of its avowed protagonists unavoidably ab- 
sent, passed the Senate unanimously in despite of the 
unprecedented and unseenly opposition of the Governor, 
and was again vetoed by him on the grounds set forth in 
his original veto message, that it was '"a meritorious 
measure regretfully refused" for want of funds, and this 
in the face of his own message setting fbrth the fine 
fiuancial condition of the State, and so for a season, a 
plan of public instruction in hygiene, upon which the leg- 



LOUISIANA SYSTEM OF HYGIEMC EDUCATION MAYER. 1187 

islative will had been twice affirmatively expressed, fell, 
through the pett}' opposition of a politician — 

" Drest in a little brief authority 
Most ignorant of what he's most assured, 
His glassy essence like an angry ap.e, 
Plays such fantastic tricks before high heaven 
As make the Angels weep." 

The passage of this Bill, and the efficient execution of 
its provisions, would have saved the State the epidemic 
of 1905, and the incidental loss of two hundred millions of 
dollars to her commerce; this bold assertion is based on 
the fact, that after the epidemic had started and was 
under full headway, a campaign of Sanitary EducatioiU 
along the lines proposed by the vetoed measure, succeeded 
in the brief period of sixty days in converting the people 
to the mosquito doctrine who for over a hundred years 
had been wedded to the f oniites theory ; even the ignorant 
colored population being converted and co-operating with 
the magnificent work of the medicos and sanitarians of 
New Orleans ; and for the first time in sanitary historj^ an 
epidemic of yellow fever was practically stamped out of a 
great center of population before the advent of frost ; and 
the commercial conscience awakened to a realization that 
"Honesty is the best policy," and that the frank admission 
of the existence of a contagious or infectious disease, to- 
gether with tangible evidence that prompt and scientific 
methods for its extinguishment are being pursued, is bet- 
ter than a policy of concealment, which always leaves in 
the public mind a belief that the evils hidden are 
infinitely worse than they really are; it is the myste- 
rious and unknown that has always carried terror to the 
human heart, full many a warrior who has hacked and 
hewn his way through aisles of bristling steel to fame, 
Avho on a hundred battle fields has proudly carried his es- 
cutcheon untarnished by a stain, has forgotten the obli- 
gations of Christian chivalry and sullied his knighthood 
with a craven and dastardly fear in the presence of un- 
known danger, or supernatural terrors, especially when 
clothed in the garb of pestilential disease. 



1188 AUGUSTIN S HISTORY OF YELLOW FEVER. 

In 1906, when Dr. 0. H. Irion became president of the 
Louisiana State Board of Health, one of his first acts was 
to carry into execution some of the measures of this 
scheme of public education, and over one hundred insti- 
tutes of hygiene were held throughout the infected area 
of the year before; where the mosquito doctrine was ex- 
pounded in a series of illustrated lectures in English, 
French, German and Italian. At these institutes the co- 
operation of the priesthood and clergy was earnestly 
sought and secured, and by their influence aided materi- 
ally in securing attentive audiences. ' The good results 
were soon apparent in the passage of screening ordinances 
in most of the towns of the State, by post-epidemic fumi- 
gation, and other sanitary steps, with the result that there 
was no recrudescence of yellow fever for the first time in 
sanitary history, in a year following an epidemic year, 
the single exception occurring in a town that had persis- 
tently neglected screening and other sanitary precautions, 
and made no effort to secure the educational advantages 
of an institute. 

This correlated educational sanitary work was followed 
by a remarkable exemption later from the incursions of 
mosquitoes, and better health conditions generally than 
had ever been observed before, during the summer and 
aiutumn following prevailed indeed, the improved condi- 
tions incident to the sanitary precautions taken in 1906, 
bore fruit as well in 1907, after they had ceased opera- 
tions, and this improvement continued until the people 
had lapsed back into the usual callous indifference that 
requires rude awakening by ej)idemic danger and constant 
preaching on sanitation. 

This institute work was supplemented by an annual 
Conference of the Sanitary Officers of the State, Parishes 
and Municipalities wherein representation was accorded 
to all educational, medical, sanitary, commercial and 
transportation bodies, and sanitary measures were ex- 
haustively discussed. At the last Conference held in 
Opelousas, the State Press Association, sitting in annual 
Convention in Lafayette, realizing the educational advan- 
tage adjourned as a body and joined the Sanitary Confer- 



LOUISIANA SVSTEM OF HYGIENIC EDUCATION MAYER. 1189 

ence oii invitation of President Irion. The Kt. Rev. James 
Blenk, Archbishop of the Diocese of New Orleans, sent 
his personal representative to this Conference, the Eev. 
Father Kavanaugh, Catholic Superintendent of Educa- 
tion; the minutes of every meeting were published by the 
daily press, so the educational propaganda was carried to 
the farthest limits of the State.*** 

During the early months of the year an Anti-Tubercu- 
losis league was organized, which has already succeeded 
in establishing a consumptive sanitarium in the ozone belt 
of the State, besides carrying on its educational work by 
the Louisiana method. The earnest and noble women 
who took the initiative in this matter are very much hand- 
icapped by want of means. 

Among tlie unique results of this hygienic educational 
work was an institute, held by an attache of the Board of 
Health, for the exclusive benefit of the nuns, nearly four 
hundred in number, under the auspices of the Superin- 
tendent of Catholic Education. The good results of 
which cannot be doubted, when it is remembered that 
most of these noble women are teachers, with a wide circle 
of influence outside the school room, and that sixty per 
cent, of their number throughout the world die of tubercu- 
losis, most frequently contracted in the rounds of their 
daily charity labors. 

The State Board of Health has endeavored to give an 
institute wherever one was desired, and is now planning 
an extensive programme commencing with a scorce of 
county fairs to be held throughout the State. The prin- 
ciple of this system has received recognition in other 

***Since this article was written, another sanitary convention 
under the auspices of the Louisiana State Board of Health 
was held in the spring of 1908, at Alexandria, which 
traversed the field of preventive medicine and was attended 
by Dr. McCormack, Secretary Kentucky Board of Health; 
Dr. Brumby, Chief Executive of the Health Department of 
Texas; Prof. Aswell, State Superintendent of Public Educa- 
tion; Dr, Caldwell, of the State Normal; Bishop Vander Ven, 
of the Catholic Diocese of Natchitoches; Dr. Kramer, Grand 
Master of the Masonic Order in Louisiana, who all delivered 
addresses. 



1190 augustin's history of yellow fever. 

states, notably in Indiana, where nnder the able adminis- 
tration of Dr. Hurty, the politicians have been whipped 
into line by the farmers who recognized the yalne of 
hygienic lectures at their Agricultural Institutes. In 
Kew York last year a start was made, indeed the Health 
Commissioner in his report claims the honor of! priority 
of a plan tentiyely tested in this State in 1885, where it 
passed the exi^erimental stage in 1897, and receiyed a mag- 
nificent accentuation by the Legislatiye Assembly of 1900 
and 1902, and by the Anti-mosquito Campaign of 1905 
and 1906, and is now the fixed policy of the State Board 
of Health, being the first practical answer to Bowditches 
plea in 1876, before the National Medical Congress in 
Philadelphia, when he said: ''Our present duty is prgan- 
ization, National, State, Municipal and Tillage, from the 
highest place in the Xational Council down to the smallest 
yillage Board of Health, we need organization, with these 
organizations we can study and often preyent disease." 

The principle underlying the Louisiana system: Edu- 
cation, hand in hand with preyenticn, has reached France, 
and is protagonized by no lesser personage than ex-Pres- 
ident Loubet in his 'Tueri-Cultur^," — Child Cultiyation, 
who has brought together the Xational Union of Presi- 
dents of Mutual Benefit Societies and the Medical and 
Pharmaceutical Union in an educational campaign on the 
plan of the Mutnalists Anti-Tuberculosis Dispensary of 
the 13th Ward of Paris, and a campaign has been started 
against food adulteration, foul air, dirt, polluted milk, 
want and sanitary ignorance. 

The results obtained by the Schneiders at Cruzot, whose 
sanitary suryeillance ofl the milk supply has reduced the 
infant m^ortality during the first year of life (the most 
dangerous period) from eighteen per cent, the ayerage for 
all France, to nine per cent, for the past year, proyes that 
no greater philanthropy or more patriotic duty confronts 
the people of our sister republic, than that now engaging 

the t houghths of ex-President Loubet.**''* 

****Tlie establishment of Infant Milk Depots, Milk" Dispensaries, 
or "Goiitte de Haut," in different parts of the world, have 
invariably lessened infant mortality. The first institution 
of the kind was established in Stamberg in 1889, followed 



LOUISIANA SYSTEM OF HYGIENIC EDUCATION MAYER. 1191 

The purve^'or of depraved milk, tlie^'great liquid food'' 
upon Avliicli so mauy imiocents depend for sustenance and 
life, is the most contemptible and sordid criminal that 
lives "unwhipped of justice/' beside whom the sneak thief, 
the burglar and the murderer stand in relative respect- 
abilit}', for he steals without the excuse of; hunger or 
other pressing want, and murders helpless innocents by 
inanition and deadly disease germs, one of Avhich alone: 
Tuberculosis', (frequently transmitted by milk) carries oft* 
fifty per cent, of the children of Christendom. 

Under these institutes, it was intended that lectures 
would be delivered on Hygiene, Quarantine, Maritimie and 
Inland, Miasmatic and Acute Contagious Diseases, Path- 
ology of Miasmatic, Contagious and Malarial Diseases, 
Bacteriology, Serum-Therapy, Physiology, Malarial Dis- 
eases, Contagious and Infectious Diseases of Children, 
Hygiene of Surgery, of the Eye, Ear, Nose and Throat, 
of the Skin, of the Moutli, Sexual Hygiene, Leprosy, Diet- 
etics, Influence of x^lcohol and Narcotics in their relation 
to Public Health, Toxicology, School Hygiene, Agricult- 
ure and Manufactories in ther relation to Hygiene, dm- 
tagious and Infectious Diseases ofl Animals, Sanitary 
Engineering, Sanitary Transportation and Disposition of 
the dead. Insane Asylums, Metereology and Climatology, 
Municipal Sanitation, Eailroad Car Sanitation, Construc- 
tion and Management of Detention and Observation 
Camps during Epidemics. Insects in their relation to 
public health. Tuberculosis restriction and prevention. 
Tuberculosis Hj-gienic, Dietetic treatment. The Louis- 
iana system has always emj)liasized the necessity of co- 
operation on the part of school authorities and teachers 
with the health authorities in securing better school 
hygiene, recognizing that '^as the twig is bent, the tree's 
inclined." and that among the children attending public 

by one at the Belleville Dispensary, Paris, in 1892; the first 
in this country was founded in New York City, by the 
philanthropist, Nathan Straus, who is indefatigable in his 
exertions to improve the milk supply furnished infants; 
, aside from the immediate good results that found their es- 
tablishment, they are valuable object lessons in pointing 
out the evils of impure milk and educating the masses to 
the danger. 



1192 

schools there were thousands who were suffering from 
preventable diseases, the direct result of ignorance both 
on the part of parents and of the children themselves; 
that the pi caching they most needed was the gospel of 
soap, and that a vast stride in the right direction would 
be made, if all the children attending the ptiblic schools 
were examined by physicians, free of cost, with special 
reference to vaccination, tuberculosis^ trachoma, decayed 
teeth, personal hygiene and malnutrition. The institute 
conductor of the Louisiana Board of Health addressed 
thousands of children in their schools during the educa- 
tional campaign of 1906, on personal and school hygiene, 
and on the subject of mosquitoes and flies as transmitters 
of disease. 

It is pleasing to note that Xew York is also taking up 
the question of more hygiene and less physical culture in 
the schools, a committee headed by an ex- Superin- 
tendent of Education, Mr. Burlingham, recently discov- 
ered an appalling condition of affairs, reporting that out 
of 600,000 school children, 46,500 are physically defective; 
that among the cases of malnutritiou, the greatest num- 
ber were found in families having an income of over 
S20.00 a week; that 72.4 per cent, had defective teeth, and 
that soaj) was an unknown quantity to thousands. 

The Louisiana system recognizes that sporadic efforts 
at teaching hygiene will not alone suflftce, that the work 
must be kept up day by day, year in and year out, with the 
same ardor that fills the teachers of religion ; if the latter 
were to stoj) preaching for only one year and the churches 
remained closed, how many lapses from grace would fol- 
low? The more true is this of the tenets of a doctrine, 
the truth of which is only beginning to. break upon the 
world,* and of a system which seeks to correlate all the 

* At the recent Anti-Tuberculosis Congress held in Washington, 
D. C, universal opinion favored p.ublic education in the 
cause and prevention of the disease as the keynote of the 
fight against its ravages and there is no doubt that had 
the Committee on Resolutions submitted to the Congress 
a resolution, sent up by Section VII, declaring it to be 
the duty of the State to furnish this instruction, it would 
have been unanimously adopted. 



LOUISIANA SYSTEM OF HYGIENIC EDLCATION MAYER. 1193 

educational factors of the State in a comprehensive effort 
to remove those ills which are the direct result of ^'igno- 
rance deep seated, far reaching, profound and appalling; 
an ignorance not confined to the lower strata of society, 
but permeating all classes; an ignorance which in its 
blind but gigantic strength is bracing its mighty shoulders 
against the pillars of the temple of Hygiea, and threaten- 
ing to engulf us in ruins darker than a buried Babylon." 

THE ENOEMOUS ECONOMIC LOSS INCIDENT TO 
EPIDEMICS. 

If one-half of the money most properly spent for the 
suppression of disease in hogs and potatoes by a paternal 
government, Avas only devoted to educating the rising 
generation in the value of prevention of disease, the good 
results following would show the wisdom of the ex- 
penditure. 

Millions are spent for the encouragement of unassimil- 
able immigrants, ignorant in many instances of our cus- 
toms, habits, speech, institutions and religion, but not one 
cent for the conservation of the lives of our people, 200,000 
of whom annually go down to a consumptive grave, the 
majority at the age of greatest productivity. The econo- 
mic loss has been conservatively set at three hundred mil- 
lions annually, aside from the humanitarian aspect, and 
taking a cold blooded, business view, it w^ould pay to edu- 
cate the masses to a proper appreciation of the dangers 
that hourly confront them. 

The American Public Health Association and the Sani- 
tary Institute of Great Britain for over a quarter of a 
century have carried on their educational work among 
sanitarians ; the Louisiana system goes a step farther and 
carries this instruction to the masses of the people, teach- 
ing themj not alone the aphorism of the Latin poet 
Martial: ''Life is not mere living but the enjoyment of 
health," and the maxim of the Roman law giver: "The 
sanitary safety of the Republic is the supreme law," but 
that the economic loss in the untimely removal of millions 
of human foot tons, at the period of their greatest produc 



. . ./. 



1194 



tivity, from communicable, preventable diseases is clue to 
Ignorance, which it is the highest duty of the State to 
enlighten. The system appeals not alone to the humanity 
but to the common sense of the American people, points 
out that the victim of a contagious or infectious disease 
is not a criminal to be hounded to earth, but the victim 
of the sanitary laches of a community^ it reiterates the 
averment of Dr. Benj. Eush : "City authorities were justly 
chargeable with the lives of all who die of preventable 
diseases within their jurisdiction, and that they should be 
made responsible before the Courts of Justice." It ful- 
fills a high civic duty in correlating all educational fac- 
tors in the State, and focusing them on the all important 
moral, economic and political necessit^^ of preserving the 
public health by reaching the masses and teaching the 
individual the value of a sound mind in a sound body, 
that to attain this it will not do to violate the sanitary 
law, and in our daily lives act — 

" As if this flesh which walls about our life 
Were brass impregnable." 

The annual address before the Orleans Parish Medical 
Society in January, 1898, was devoted to this topic, and 
an elaborate plan for a State Institute of Hygiene pro- 
posed which has never been carried into complete execu- 
tion for want of means, the economic value of such a 
System is beginning to be appreciated, and the day 
is not far distant when every civilized State will 
have an Institute of Hygiene on the Louisiana plan, 
'with a National Institute to supplement the work of the 
States, and an International Institute to focus a world 
wide movement in public instruction in hygiene, when 
the world will awaken to a realizing sense that an epi- 
demic is the remorse of a guilty community, guilty of sani- 
t^rj laches, guilty of pollutions and desecrations of the 
Sacred Altar of Hygiea, in the words of Aristotle: 
"Of all these things the judge :s time." 



